Medium to long-term echo follow-up after ventricular septal defect device closure.
OBJECTIVE
We aimed to assess the medium to long-term results of echocardiographic follow-up of perimembranous and muscular ventricular septal defect closure with various Amplatzer devices.


METHODS
We successfully closed ventricular septal defects percutaneously in 45/49 patients. There were 35 perimembranous and 10 muscular ventricular septal defects. The median age and weight was 8.50 years (range 2-36.70 years) and 24 kg (range 10-106 kg), respectively. The median size of the ventricular septal defect was 7 mm (range 3-14 mm) on transthoracic echocardiography, 6 mm (range 4-15 mm) on transesophageal echocardiography, and 6 mm (range 3-14 mm) on left ventricular angiography. The median pulmonary-to-systemic blood flow ratio was 1.40 (range 1.0-3.0).


RESULTS
In the 49 attempted cases, the procedure was successful in 45, with a success rate of 91.84%. At a mean follow-up of 54.50 months, echocardiography showed complete closure in 41 (91%) patients and 4 (9%) had a tiny (1-2 mm) residual defect. New-onset aortic regurgitation was seen in 6 (13.3%) patients at 54.50 months, but it was mild in nature. Tricuspid valve regurgitation was observed in 13 (29%) patients at 54.50 follow-up, of whom 10 (22%) had mild and 3 (7%) had moderate regurgitation.


CONCLUSIONS
Transcatheter closure of perimembranous and muscular ventricular septal defects is effective, however, these patients need to be followed up regularly to detect device-related problems, specifically, aortic and tricuspid valve regurgitation.
Division of Pediatric Cardiac Surgery, Hamad General Hospital, Doha, Qatar.
Muhammed Riyas K
MR
Rahmath
Division of Pediatric Cardiology, University of Texas, Houston, TX, USA.
Mohammed
M
Numan
Pediatric cardiology, Dept of pediatrics, HGH,Doha, Qatar dilawarmd@yahoo.com.
Muhammad
M
Dilawar
D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055989:Septal Occluder Device; D013997:Time Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D055815:Young Adult
Aortic valve regurgitation; Device closure; Tricuspid valve regurgitation; Ventricular septal defect