Key result
Transcatheter VSD closure improves LVEF and GLS at 6 months.
Why the study?
Advances in 3D echocardiography and derived speckle tracking can be used to evaluate ventricular performance and assess left ventricular remodeling after transcatheter closure of ventricular septal defect.
Does transcatheter VSD closure improve left ventricular reverse remodeling and strain parameters in children with congenital VSD?
Does transcatheter VSD closure improve left ventricular reverse remodeling and strain parameters in children with congenital VSD?
Transcatheter closure of VSD in children leads to significant short- and intermediate-term improvements in left ventricular ejection fraction and 3D speckle tracking-derived strain parameters.
Associated with short-term LV function gains after pediatric transcatheter VSD closure; extends observational data but leaves open need for RCTs.
Background Nowadays Transcatheter closure of VSD as an alternative option to surgical closure has gained great acceptance due to high success rate and less risk of complications. With the advances in the 3 D echocardiography and the derived 3D speckle tracking and global longitudinal strain ,they can be used to assess ventricular performance after VSD transcatheter closure, to assess the left ventricular remodeling after VSD transcatheter closure . Results This was a prospective observational study which included two groups; study group which included 56 children with congenital VSD undergoing transcatheter VSD device closure, and control group which included 56 normal children with matching age and sex over 12 months . Patients with either perimembranous subaortic VSD or muscular VSDs amenable for transcatheter closure were included in the study . All patients under went 3D speckle tracking echocardiography for measurements of global longitudinal , radial and circumferential strain before , immediately after and 6 months after VSD transcatheter closure . A total of 56 patients with peri membranous or muscular VSD were included with mean age of 6.70 ± 4.47 yrs , mean wight of 22.48±13.79 kg, mean BSA of 0.83 ± 0.32 m2. 3D echo data revealed , there was no significant decrease in the in the LV EDVI and LV ESVI in the 6 months follow up however there was significant improvement in ventricular functions from (50- 62 % to 56- 66 %) p value 0.001 ) . Global longitudinal strain increased ( from -15 - -20 % to -18 - -21 %) P value = 0.001 , Global circumferential strain increased ( from -13 % - - 23 % to -20 % - 24 %) P value= 0.001 , Global radial strain increased ( from 28 % - 45 % to 35 – 50 % ) P value 0.001. Conclusion This study proves the significant improvement in 3D echocardiography derived Ejection fraction and global longitudinal strain after VSD transcatheter closure which reverses the LV remodeling with good short term and intermediate outcome.comparison of the 2 groups 3D echo data comparison of the 2 groups 3D echo data
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Eldin et al. (2025) studied this question. VSD transcatheter closure significantly improved LV ejection fraction (50-62% to 56-66%, p=0.001) and global longitudinal strain (-15 to -20% to -18 to -21%, p=0.001) at 6 months.
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