Key result
KONAR-MF occluder safely closes pediatric muscular VSDs, reducing mean pulmonary artery pressure to ~19 mmHg.
Why the study?
The KONAR-MF occluder has broadened the feasibility of transcatheter muscular ventricular septal defect closure, particularly in infants, but multicentre paediatric outcomes needed assessment.
Does transcatheter and hybrid closure using the KONAR-MF™ occluder improve outcomes and safety in paediatric patients with muscular ventricular septal defects?
Does transcatheter and hybrid closure using the KONAR-MF™ occluder improve outcomes and safety in paediatric patients with muscular ventricular septal defects?
The KONAR-MF™ occluder is a safe and effective option for transcatheter closure of muscular ventricular septal defects in paediatric patients, significantly reducing pulmonary artery pressures with minimal complications.
May be considered for paediatric muscular VSD closure using the KONAR-MF™ occluder; extends evidence for transcatheter and hybrid approaches in this population.
Background: The KONAR-MF™ occluder, with its flexible medium-profile design, has broadened the feasibility of transcatheter closure of muscular ventricular septal defects, particularly in infants. Objective: To assess feasibility, safety, techniques, and outcomes of muscular ventricular septal defect closure using the KONAR-MF™ occluder in a multicentre paediatric cohort. Methods: A retrospective review was conducted at three tertiary paediatric cardiac centres (2018–2024). Patient demographics, ventricular septal defect characteristics, procedural approaches, and follow-up outcomes were analysed. Device implantation was performed via retrograde, antegrade, transseptal, or hybrid approaches under fluoroscopic and echocardiographic guidance. Results: Fifty patients (54 devices) were included (median age: 48 months [interquartile range 12–96]; weight: 12 kg [interquartile range 7.5–23]), including 14 infants (9 < 7 kg). Indications were failure to thrive (46%), heart failure (28%), recurrent infections (12%), and postoperative residual ventricular septal defect (14%). The mean ventricular septal defect size was 5.8 ± 2 mm. Median fluoroscopy time was 18 minutes (range: 3–71). Residual shunts were present in 18% immediately, reducing to 9% at one week and resolving by three months. Mild, transient tricuspid regurgitation occurred in 14%. Over a median 9-month follow-up (range 1–60), no cases of heart block or haemolysis occurred. One embolisation required surgical retrieval. Pulmonary artery pressure decreased significantly (37 ± 13.4 to 19 ± 3.8 mmHg, p < 0.001). Conclusions: Transcatheter closure of muscular ventricular septal defects with the KONAR-MF™ occluder is safe, effective, and versatile across paediatric age groups, including infants and postoperative cases. High success rates, minimal complications, and favourable short- to mid-term outcomes support its use in routine practice.
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Sastry et al. (2026) studied this question. The KONAR-MF™ occluder safely closed muscular ventricular septal defects in 50 pediatric patients, significantly reducing mean pulmonary artery pressure from 37 to 19 mmHg (p < 0.001).
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