Transcatheter closure of VSDs achieved a 93.3% success rate with no mortality or complete heart block, and only 6.7% procedural failures over a decade in 149 patients.
Does transcatheter closure of ventricular septal defects safely achieve procedural success and improve ventricular remodeling in patients with hemodynamically significant VSDs?
Transcatheter closure of ventricular septal defects using modern devices is highly effective and safe, achieving a 93.3% success rate with no instances of complete heart block and significant positive ventricular remodeling.
Absolute Event Rate: 0% vs 0%
Background Ventricular septal defects (VSDs) are the most common congenital heart defects, with outcomes influenced by size and location. Transcatheter closure (TCC) has become a widely used option for repair. This study presents a decade‐long institutional experience with TCC of VSDs, evaluating its safety and efficacy. Methods This retrospective study analyzed patients who underwent attempted TCC of VSDs between 2015 and 2024. Patients were selected based on clinical and hemodynamic significance, and indications for closure were heart‐failure symptoms and a Qp:Qs ratio exceeding 1.5. Procedural success, complications, and ventricular remodeling were analyzed as primary outcomes. Results A total of 149 patients (51% male) were included; of these, 23 (15.4%) patients were local (Israeli) and 126 (84.6%) were foreign nationals. The mean age was 86.67 ± 57.13 months. Successful closure was achieved in 139 patients (93.3%). The mean defect diameter was 4.72 ± 1.82 mm. The majority had perimembranous defects (111 patients, 74.5%). ADO II devices (96 cases, 65%) and MFO devices (49 cases, 33%) were predominantly used. The retrograde approach was employed in 136 (92%) of cases. The most notable complication was a residual shunt adjacent to the device, detected in 21 patients (15.1%) at a 1‐week follow‐up; 19 patients (13.7%) had mild residual shunts and 2 patients (1.4%) had moderate residual shunts. In the long‐term follow‐up cohort, residual shunt persisted in 3 of 52 patients (5.8%), all of which were mild. No mortality or instances of complete heart block were reported. Overall, 10 procedures (6.7%) failed. Device embolization occurred in six cases (4%), five of which required surgical intervention. Univariable analysis showed significantly higher LVEDD Z‐score, Qp:Qs ratio, defect diameter, and systolic pulmonary artery pressure in failed cases. In further analysis for pmVSD patients, device choice and subaortic rim were also significantly associated with failure. Conclusions This decade‐long experience demonstrates TCC as a safe and effective treatment for VSDs, with high success rates and minimal complications.
Amer et al. (Thu,) reported a other. Transcatheter closure of VSDs achieved a 93.3% success rate with no mortality or complete heart block, and only 6.7% procedural failures over a decade in 149 patients.