Patching Device Repairs Hole in Heart

Ventricular septal defects are rare but potentially deadly

By Ed Edelson
HealthDay Reporter

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THURSDAY, May 10 (HealthDay News) -- Emergency use of a patching device can help patients avoid high-risk surgery when a heart attack tears a hole between the ventricles, the lower blood-pumping chambers of the heart, researchers report.

"These patients often are too ill to go to surgery at once," explained Dr. Matthew W. Martinez, a cardiology fellow at the Mayo Clinic in Rochester, Minn. "What we are doing is bridging these people so that they become stable enough to survive surgery."

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These types of dangerous cardiac tears, called a "ventricular septal defect", are fortunately rare and occur in less than 1 percent of heart attacks, according to Martinez. However, drug treatment leaves patients with a 90 percent risk of death, while surgery carries a 50 percent death rate, so any alternative is welcome, he said.

He was expected to present his team's results Thursday at the annual scientific sessions of the Society for Cardiovascular Angiography and Interventions, in Orlando.

Martinez described 10 patients whose ventricular septal defects were treated at the Mayo Clinic with the patching device between 1995 and 2005. Dr. Donald J. Hagler, professor of pediatrics, also helped perform the procedures.

Five of the heart wall ruptures were caused by heart attacks, and five were unintended consequences of prior heart surgery.

Hagler used various forms of a device called the Amplatzer Occluder, manufactured by a Minnesota company, which consists of two discs connected by a thick shaft.

The device is threaded in collapsed form into the heart by a catheter and is opened at the site of the rupture in the ventricle walls. It is made of flexible nitinol metal and covered with a polyester fabric. New heart tissue can grow on this fabric, repairing the hole permanently.

Unless something is done to close the hole, blood shoots backward from the left to the right ventricle -- rather than into the body -- with each heartbeat, causing severe heart failure.

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