A Comparative Study: Early Results and Complications of Percutaneous and Surgical Closure of Ventricular Septal Defect

Abstract

Objective: Given the increasing popularity of percutaneous closure of ventricular septal defects (VSDs), a comparative analysis of the different treatments (surgical vs. percutaneous closure) for VSDs is needed. Methods: This is a single center, retrospective clinical study. A total of 2,178 patients with VSDs were enrolled, including 852 patients treated with percutaneous closure (device group) and 1,326 patients underwent traditional surgical repair (surgical group). Several characteristics (e.g. procedure success rate, complications, blood transfusions) were compared between the 2 groups. Results: There were no differences (p > 0.05) between the device and surgical groups according to the success rates (99.8 vs. 100%) and occurrences of main complications (1.9 vs. 2.5%). The incidence of minor complications was significantly lower in the device group (0.6%, 5/852) than the surgical group (6.4%, 85/1,326) (p < 0.01). No blood transfusions were needed in the device group, while 136 patients (10.3%) required blood transfusions in the surgical group. The duration of hospital stay was shorter in the device group than in the surgical group (3.2 vs. 12.9 days, p < 0.01). Conclusion: Percutaneous VSD closure is an effective method with fewer complications, shorter hospital stay and good cosmetic effect. It can serve as a reasonable alternative treatment for traditional open heart surgery.

Transcatheter closure of perimembranous ventricular septal defect with muscular VSD occluder after infective endocarditis in a patient with previous primum atrial septal defect closure, prosthetic aortic and mitral valves replacement. (RCD code IV-2B.3)

“…However, in the published case series regarding perimembranous VSDs closure with muscular VSD occluders, atrioventricular blocks were not observed. The risk of these major complications and the success rate were reported to be similar in comparison to surgical procedures [1,2,[5][6][7][8][9].…”

Transcatheter closure of perimembranous ventricular septal defect in children: Safety and efficiency with symmetric and asymmetric occluders

“…Previous success rates ranged between 89 and 100% [9,10,[13][14][15][16][17]. Procedural failures reported in the literature were mainly due to HBs, device-related aortic or tricuspid regurgitation, significant residual shunts, device embolization, inability to securely position the device, and failure to position the delivery sheath to the left ventricle apex [10,[17][18][19][20].…”

“…In 2002, the Amplatzer asymmetric VSD occluder (AVSDO) was specifically designed for treatment of perimembranous ventricular septal defect (PMVSD) patients who have a short rim between the PMVSD and aortic valve [8][9][10][11][12][13]. In 2004, the symmetric ventricular septal defect occluder (SVSDO) was introduced and is mainly used in patients with a long rim separating the PMVSD and aortic valve.…”

Ventricular Septal Defect Closure: What Is the Role for Transcatheter Closure?

“…No patient had complete heart block requiring permanent pacing. An interesting comparison was that their median postoperative length of stay was 5 days in comparison to the 12.9 days in the series from Zheng et al [1] . Kogon et al [6] from the Egleston Children's Hospital in Atlanta recently reported 225 patients undergoing VSD closure.…”

“…Of course, the problem with any retrospective, non-randomized comparison is that different pathologies were undoubtedly stratified to different treatment strategies. In particular, the size of the VSDs in the device group ranged from 3 to 12 mm and in In this issue of Cardiology, Dr. Zheng et al [1] from the Xijing Hospital (Xi'an, China) have reported their results of a comparative study between percutaneous and surgical closure of ventricular septal defects (VSD). During a 3-year time period (2004-2007), 2,178 patients underwent VSD closure: 852 via the percutaneous approach and 1,326 via the traditional surgical procedure.…”