Transcatheter device closure of perimembranous ventricular septal defects: mid-term outcomes.
OBJECTIVE
The aim of this study was to evaluate the safety and efficacy of transcatheter closure for perimembranous ventricular septal defect (pmVSD) and its long-term results. The most common congenital heart condition is pmVSD. Transcatheter closure of pmVSD is a recently described technique with limited results for mid- to long-term follow-up.


RESULTS
Between June 2002 and June 2008, 848 patients with pmVSD were enrolled in our study and treated percutaneously with pmVSD occluders. All patients were followed up until December 2008, an average of 37 months. According to colour Doppler transthoracic echocardiography before the intervention and ventriculography, the average end-diastolic pmVSD size was 5.1 and 5.4 mm, respectively. Placement of the device was successful in 832 patients (98.1%) and the median device size was 8.6 mm. During follow-up, 103 adverse events (12.4%) were reported. Most adverse events were categorized as minor and there were nine major adverse events (8.7%), including two complete atrioventricular block requiring pacemaker implantation. Kaplan-Meier estimates showed >85% freedom from major or minor adverse events during a maximal follow-up of 79 months.


CONCLUSIONS
In experienced hands, transcatheter pmVSD closure can be performed safely and successfully with low morbidity and mortality. Long-term prognostic results are favourable, and the transcatheter approach provides a less-invasive alternative that may become the first choice in selected pmVSD patients. This trial is registered with ClinicalTrials.gov, number NCT00890799.
Yang
Jian
J
Xijing Cardiovascular Hospital, Fourth Military Medical University, Xi'an, China.
Yang
Lifang
L
Wan
Yi
Y
Zuo
Jian
J
Zhang
Jun
J
Chen
Wensheng
W
Li
Jun
J
Sun
Lijun
L
Yu
Shiqiang
S
Liu
Jincheng
J
Chen
Tao
T
Duan
Weixun
W
Xiong
Lize
L
Yi
Dinghua
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D055989:Septal Occluder Device; D055815:Young Adult
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