[Short- and mid-term outcomes of arrhythmia after transcatheter and surgical closure of membranous ventricular septal defects: a comparative analysis].
OBJECTIVE
To evaluate the short- and mid-term outcomes of arrhythmia in patients undergoing transcatheter and surgical closure of membraneous ventricular septal defect (VSD).


METHODS
358 VSD patients, 161 male and 197 female, aged (11 +/- 8), underwent transcatheter closure and 50 sex, age, body weight, size of membranous VSD, and percentage of complicated membranous aneurysm-matched VSD patients underwent surgical closure. Electrocardiography was conducted 1, 3, 6, and 12 months after VSD closure.


RESULTS
Except bundle branch block other kinds of arrhythmia were resolved in all the patients prior to discharge. The arrhythmias occurring in the patients who underwent transcatheter closure of VSD included complete right bundle branch block (CRBBB, 4 5%), incomplete right bundle branch block (IRBBB, 10.1%), left anterior fascicular block (LAFB, 2.8%), IRBBB complicated with LAFB (1.7%), and CRBBB complicated with LAFB (0.6%), while in the patients who underwent surgical closure included CRBBB (26%) and IRBBB (28%). At the end of 12 months of follow-up, of the 180 patients who had undergone interventional therapy 6 showed CRBBB (3.3%), 6 showed IRBBB (3.3%), 3 showed CRBBB complicated with LAFB (1.7%) and one showed third degree auriculo-ventricular block (0.56%) s, however, no significant change in the ECG findings occurred in the patients who had undergone surgical closure.


CONCLUSIONS
Transcatheter occlusion of membraneous VSD is safer than surgical closure. IRBBB and LAFB caused by interventional therapy are benign, the majority of which may resolve itself 6 - 12 months after the procedure. However, CRBBB and CRBBB complicated with LAFB need a long-term follow-up.
Zhu
Xian-Yang
XY
Department of Congenital Heart Disease, Cardiovascular Institute of People's Liberation Army & General Hospital of Shenyang Military Command, Shenyang, China.
Liu
Yu-Hao
YH
Han
Xiu-Min
XM
Hou
Chuan-Ju
CJ
Sheng
Xiao-Tang
XT
Zhang
Duan-Zhen
DZ
Cui
Chun-Sheng
CS
Deng
Dong-An
DA
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006345:Heart Septal Defects, Ventricular / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome