The Comparison of Perventricular Device Closure with Transcatheter Device Closure and the Surgical Repair via Median Sternotomy for Perimembranous Ventricular Septal Defect

Fang, Guan-Hua; Chen, Qiang; Hong, Zhi-Nuan; Lin, Zewei; Zhang, Gui-Can; Cao, Hua

doi:10.5761/atcs.oa.18-00085

Cited by 17 publications

(43 citation statements)

References 27 publications

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“…Then, the occluder was advanced to the tip of the sheath, and the left disc was first deployed followed by the right disc. TEE assessment was performed to detect residual shunt or valve dysfunction [10–12].…”

Section: Methodsmentioning

confidence: 99%

“…The transcatheter technique is acceptable for patients with an excellent rate of closure and only leaves a puncture on the surface, which offers an impressive cosmetic result [8, 9]. Recently, intraoperative device closure of VSD under the guidance of transesophageal echocardiography (TEE) has been widely and successfully used in China, and previous reports have already proven its feasibility and safety [10–12]. With regard to the incidence of a particular functional impairment in the cardiac population, health-related quality of life (HRQOL) has already been used as an essential assessment of cardiac operations [13–15].…”

Section: Introductionmentioning

confidence: 99%

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Health-related quality of life in children and adolescents undergoing intraoperative device closure of isolated perimembranous ventricular septal defects in southeastern China

Huang

Kim

et al. 2019

J Cardiothorac Surg

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ObjectivesTo investigate the health-related quality of life (HRQOL) in children and adolescents who underwent intraoperative device closure of perimembranous ventricular septal defects (pmVSDs).MethodsFrom October 2017 to January 2018, a total of 126 children and adolescents with isolated pmVSDs who underwent intraoperative device closure were enrolled in this study. We used the Pediatric Quality of Life Inventory Measurement Models 4.0 generic core scales to measure HRQOL 24 h before the operation and three months and one year after surgery.ResultsA total of 126 patients were successfully occluded. No severe complications occurred during the operative time, and 1 case of Mobitz type I atrioventricular block (AVB) and 1 case of complete cAVB occurred during the postoperative period. Compared with the data before the operation, the total score and five domain scores, including physical, psychosocial, emotional, social and psychological functioning, were significantly higher at three months after the operation. In addition, the total score, physical functioning score, and the psychosocial functioning score at the 1-year follow-up were even higher than those at 3 months after the operation.ConclusionsThe present study suggests that intraoperative device closure of pmVSD could improve health-related quality of life in children/adolescents and that the improvement may progress as the time after the operation increases. Further studies should concentrate on comparisons with other medical methods, larger samples, and longer follow-up periods.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in children and adolescents undergoing intraoperative device closure of isolated perimembranous ventricular septal defects in southeastern China

Huang

Kim

et al. 2019

J Cardiothorac Surg

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“…If closure cannot be achieved or any complication occur, a rapid transition to open-heart surgery is possible [ 2 , 3 , 5 , 7 , 8 , 11 - 13 ] .…”

Section: Discussionmentioning

confidence: 99%

Hybrid Transthoracic Periventricular Device Closure of Ventricular Septal Defects: SingleCenter Experience

Öztürk

et al. 2021

Braz J Cardiovasc Surg

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Objective To evaluate the efficacy of hybrid transthoracic periventricular device closure of ventricular septal defects (VSDs) in a single center. Methods All patients who underwent hybrid transthoracic periventricular device closure of VSDs between January 2018 and December 2019 were retrospectively analyzed. The preoperative, operative and postoperative findings and clinical follow-ups were reviewed. Results A total of 59 patients underwent the procedure. Transesophageal echocardiographic guidance was used in all procedures. The procedure was successful in 57 procedures (97%). The procedures of two patients were changed to open-heart surgery during the same intervention due to severe aortic insufficiency (the device was not deployed) and significant residual shunt after device deployment. One major complication (1.7%) was observed after the procedure. The patient’s device was dislodged within 12 hours after the procedure, and this patient underwent device extraction and VSD patch closure due to significant residual shunt. Eight (14%) minor complications were observed after the procedure, and three of them persisted during follow-up. Three of these eight complications were incomplete right bundle branch block, one of which resolved during follow-up; two were mild residual shunts, one of which resolved during follow-up; two were mild new-onset tricuspid valve insufficiencies; and one was mild new-onset mitral valve insufficiency; all valvular insufficiencies were resolved during follow-up. Conclusions Hybrid transthoracic periventricular device closure of VSD seems to be a good alternative approach due to its procedural success and low risk rates. The best advantage of the procedure is the possibility of switching to open-heart surgery, if necessary.

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“…1). A total of 15 articles [11–25] were included and further analyzed. Eight studies were case series, and the other 7 studies were case-control studies.…”

Section: Methodsmentioning

confidence: 99%

A meta-analysis of perventricular device closure of perimembranous ventricular septal defect

Hong

Chen

Huang

et al. 2019

J Cardiothorac Surg

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Background To investigate the safety and efficacy of perventricular device closure of perimembranous VSD (pmVSD). Methods PubMed and Scopus were searched for studies in English focusing on perventricular device closure of pmVSD published up to the end of March 2019. We used a random-effects model to obtain pooled estimates of the success and complication rates. Results A total of 15 publications comprising 1368 patients with pmVSD were included. The median follow-up duration was 2 months to 5 years, with a mean patient age ranging from 2 months to 56 years. The pooled success rate was 0.95 (I 2 = 86.2%, P = 0.000). The pooled rate of postoperative residual shunting was 0.02 (95% CI: 0.01–0.03, I 2 = 87.3%, P < 0.001). The pooled rate of residual shunting in the follow-up period was 0.001 (95% CI:-0.001–0.002, I 2 = 30.5%, P = 0.126). The pooled estimated rate of severe complications was 0.074 (95% CI: 0.046–0.102, I 2 = 30.5%, P = 0.126). The pooled incidence of complete atrioventricular block (cAVB) was 0.002 (95% CI: 0.000–0.005, I 2 = 0.0%, P = 0.577). Conclusions Perventricular device closure may be an alternative to conventional surgical repair in selected patients with pmVSD. The success rate was stable regarding the publication year and sample size and suggested both the short learning curve of this technology and its potential for wide application. The incidence of severe arrhythmia, especially cAVB, was low. These good results may be limited by the number of enrolled patients, and a more detailed and larger sample is required for further analysis.

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The Comparison of Perventricular Device Closure with Transcatheter Device Closure and the Surgical Repair via Median Sternotomy for Perimembranous Ventricular Septal Defect

Abstract: Device closure may be alternative to conventional surgical repair for patients with isolated pmVSD. Perventricular device closure was the preferred procedure because it showed more maneuverable than transcatheter procedure with the same clinical result.

Cited by 17 publications

References 27 publications

Health-related quality of life in children and adolescents undergoing intraoperative device closure of isolated perimembranous ventricular septal defects in southeastern China

Health-related quality of life in children and adolescents undergoing intraoperative device closure of isolated perimembranous ventricular septal defects in southeastern China

Hybrid Transthoracic Periventricular Device Closure of Ventricular Septal Defects: SingleCenter Experience

A meta-analysis of perventricular device closure of perimembranous ventricular septal defect

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