Transcatheter device closure of ventricular septal defects in children: a retrospective study at a single cardiac center

Saad Q Khoshhal, Mansour B Al-Mutairi, Abdulhameed A Alnajjar, Mohamed M Morsy, Sherif S Salem, Mustafa Al-Muhaya, Khaled M El-Harbi, Hany M Abo-Haded, Saad Q Khoshhal, Mansour B Al-Mutairi, Abdulhameed A Alnajjar, Mohamed M Morsy, Sherif S Salem, Mustafa Al-Muhaya, Khaled M El-Harbi, Hany M Abo-Haded

Abstract

Background: Ventricular septal defect (VSD) is the most common congenital heart disease in the pediatric population. Nowadays, trans-catheter closure is considered a feasible method of therapy for most muscular and some perimembranous types of VSDs.

Objective: Assess the safety, efficacy and outcome of percutaneous transcatheter closure of VSDs in children.

Design: Retrospective, single center study.

Setting: Madinah Cardiac Center, Madinah, Saudi Arabia.

Patients and methods: The study included all consecutive children who underwent transcatheter closure of isolated VSD during the period from December 2014 to January 2019. The data were collected from hospital database medical records. Transthoracic echocardiography (TTE) and an electrocardiogram (ECG) were done before and after the procedure in all the patients. The device was implanted by the retrograde or antegrade approach. All patients were subjected to follow-up evaluation at 1, 3, 6, 12 months, and annually thereafter with TTE and ECG.

Main outcome measures: Procedure success rate, clinical follow-up, TTE.

Sample size: 70 children.

Results: The mean (standard deviation) age of patients was 10.2 (4.1) years (range: 2-18 years), and their mean body weight was 30.9 (13.9) kg (range: 7.0-57.7 kg). Forty-eight (68.6%) children had muscular VSD (mVSD), and 22 (31.4%) children had perimembranous VSD (pmVSD). The majority of defects were closed via the retrograde approach using the Amplatzer muscular occluder device. At 24 hours after the procedure, the success rate was 90%. Only four (5.7%) cases had major adverse events including complete atrioventricular block, hemolysis, and thrombus formation.

Conclusion: Transcatheter closure is a safe and feasible procedure in VSDs of various morphologies, with a low adverse event rate.

Limitations: Retrospective design, single-center study, absence of control group.

Conflict of interest: None.

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