A Comparative Study of Perventricular and Percutaneous Device Closure Treatments for Isolated Ventricular Septal Defect: A Chinese Single-Institution Experience

Abstract

Objectives To compare the advantages and disadvantages of perventricular and percutaneous procedures for treating isolated ventricular septal defect (VSD). Methods A total of 572 patients with isolated VSD were selected in our hospital between January 2015 and December 2016. The patients’ median age and weight were five years (1-26 years) and 29 kg (9-55 kg), respectively. The median diameter of VSD was 6.0 mm (5-10 mm). Patients were divided into two groups. In group A, perventricular device closure was performed in 427 patients; in group B, 145 patients underwent percutaneous device closure. Results Four hundred twelve patients in group A and 135 patients in group B underwent successful closure. The total occlusion rate was 98.5% (immediately) and 99.5% (3-month follow-up) in group A, which were not significantly different from those in group B (97.7% and 100%, respectively). Patients in group A had longer intensive care unit (ICU) stay than those in group B, but patients in group B experienced significantly longer operative times than those in group A. The follow-up period ranged from 8 months to 1.5 year (median, 1 year). During the follow-up period, late-onset complete atrioventricular block occurred in two patients. No other serious complications were noted in the remaining patients. Conclusion Both procedures are safe and effective treatments for isolated VSD. The percutaneous procedure has obvious advantages of shorter ICU stay and less trauma than the perventricular procedure. However, the perventricular procedure is simpler to execute, results in a shorter operative time, and avoids X-ray exposure.

Single-stage off-pump repair of coarctation of the aorta and ventricular septal defects in children

“…Although few patients had transitory rhythm disturbances during the study, some of them returned with complete AV block and had a pacemaker implanted permanently. Some authors have mentioned that, in case of early complete AV block due to mechanical injury during manipulation of the delivery system or during device implant, conversion to open surgery should be considered [ 7 , 10 ]. The cause of late-onset complete AV block remains unknown, but it probably occurs as a result of chronic inflammation and fibrosis due to the device, which is more likely to occur in infants with large defects.…”

Syndrome of Ventricular Septal Defect and Aortic Regurgitation — A 22-Year Review of its Management

“…The procedure has been shown to be safe and feasible in the setting of AR. In a recent review for the safety of device closure for VSD, it was found that percutaneous and perventricular device closure for VSD are safe and did not have any extra morbidity [ 15 ] .…”

Transthoracic closure of ventricular septal defects guided by transesophageal echocardiography

“…Comparing transthoracic and transcatheter device closure of VSD, the transthoracic procedure provides a shorter path and a more perpendicular angle to the defect. [23] During both procedures of device closure, the most important step is to guide the wire through the VSD to establish the delivery track. Based on our experience with color Doppler imaging by TEE, the wire was easy to aim toward and through the VSD during the transthoracic procedure.…”