Key result
Transcatheter closure of outlet VSDs achieves ~76% procedural success with low short-term complications.
Why the study?
Outlet ventricular septal defects are notably prevalent in North-Eastern India and frequently associated with aortic valve prolapse; while surgery is conventional, transcatheter closure effectiveness required exploration.
Does transcatheter closure using various devices safely and effectively treat outlet and outlet muscular ventricular septal defects in selected patients?
Observational (n=21)
No
Does transcatheter closure using various devices safely and effectively treat outlet and outlet muscular ventricular septal defects in selected patients?
Effect estimate: 76.2% success rate
Transcatheter closure of outlet and outlet muscular VSDs is feasible and yields positive short- to mid-term outcomes in carefully selected patients, offering an alternative to conventional surgical repair.
Supports consideration as less invasive alternative in selected outlet VSD patients; extends feasibility evidence but leaves open need for randomized trials.
Background Outlet septum ventricular septal defects (VSDs) are notably more prevalent in North-Eastern India and often associated with aortic valve prolapse, leading to a need for surgical intervention. While surgical methods remain the conventional approach, there is an opportunity to explore the effectiveness of transcatheter closure techniques. Objective and Methodology This study aimed to assess the effectiveness and follow-up of transcatheter closure for outlet and outlet muscular type VSDs using three distinct devices: Amplatzer ADO II, KONAR MF VSD Occluder, and Cocoon VSD Occluder. This Descriptive study with follow-up observation up to 1 year was conducted at Health City Hospital in Guwahati, India, from March 2023 to November 2025, involving 21 patients who met the criteria for inclusion. Results Among the 21 patients, transcatheter closure was successfully achieved in 16 individuals, resulting in a success rate of 76.2%. The mean diameter of the VSDs was 3.8 mm, with 66.6% of the cases showing pre-existing aortic valve prolapse. Closure attempts were unsuccessful in five patients, who subsequently received surgical intervention. In the successful cases, the Amplatzer ADO II was implanted in 7 patients (43.7%), the KONAR MFO in 8 patients (50%), and the Cocoon VSD occluder in 1 patient (6.3%). Seven patients exhibited mild intra-device residual shunts, and 37.5% (6/16) experienced a transient increase in aortic regurgitation (AR) after 24 hours post-procedure. Importantly, follow-up after one year showed static or non-progression of pre-existing AR, with worsening of AR (moderate severity) observed only in one patient, and the majority of residual shunts resolved. No major complications like outflow obstruction or device embolization were reported in the present study. Conclusion The results indicate that transcatheter closure of outlet and outlet muscular type VSDs is a promising option for selected patients, yielding positive short- to mid-term outcomes. Further long-term follow-up will enhance our understanding of the procedure’s safety and efficacy, paving the way for broader application of this technique in clinical practice.
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Das et al. (2026) conducted an observational in Patients with outlet and outlet muscular ventricular septal defects (VSDs), age >1 year, with or without mild to moderate aortic valve prolapse, without more than mild aortic regurgitation, excluding those with large defects (>8 mm) or moderate/severe AR, mostly children and adolescents from North-Eastern India (n=21). Transcatheter closure of outlet and outlet muscular VSD using Amplatzer ADO II, KONAR MF VSD Occluder, and Cocoon VSD Occluder was evaluated on Procedural success rate of transcatheter closure of outlet and outlet muscular VSD (76.2% success rate). Transcatheter closure of outlet and outlet muscular ventricular septal defects achieved a procedural success rate of 76.2% with acceptable 1-year outcomes including stable aortic regurgitation and low complication rates.
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