Cardiovascular events in perimembranous ventricular septal defect with left ventricular volume overload: a French prospective cohort study (FRANCISCO)

Abstract

Brief summary The long-term prospective multi-centre nationwide (French) observational study FRANCISCO will provide new information on perimembranous ventricular septal defect with left ventricular overload but no pulmonary hypertension in children older than 1 year. Outcomes will be compared according to treatment strategy (watchful waiting, surgical closure, or percutaneous closure) and anatomic features of the defect. The results are expected to provide additional guidance about the optimal treatment of this specific population, which is unclear at present.

Comparative outcomes of two competitive devices for retrograde closure of perimembranous ventricular septal defects

“…The management of children with hemodynamically significant but restrictive-type pmVSD remains controversial with no clear guidelines ( 23 ). These defects are managed either by watchful waiting or by closure, depending on the clinical symptoms and practice patterns at each center.…”

“…On the one hand, “prophylactic” closure is often advocated to avoid late LV dysfunction related to cardiac volume overload. However, this complication has not been well-described and some centers consider that the benefits may not outweigh the risks of surgical or percutaneous closure ( 23 – 25 ). On the other hand, watchful waiting is supported by the good tolerance of the shunt after one year of age ( 26 – 28 ).…”