Transcatheter VSD closure in children achieved a 93% procedural success rate, with Nit-Occlud devices associated with higher residual shunt rates than other occluders (85.7% vs. 33.0%, p=0.010).
Cohort (n=118)
Is transcatheter ventricular septal defect closure safe and effective in children?
Transcatheter VSD closure in children demonstrates high procedural success (93%) and acceptable complication rates, with outcomes influenced by device choice, defect size, and patient weight.
BACKGROUND: Transcatheter closure has become a widely accepted alternative to surgery for VSD, but long-term pediatric data are limited. This study evaluated procedural success, complications, and long-term outcomes with different occluders. METHODS: We retrospectively analyzed 118 children who underwent attempted transcatheter VSD closure between 2014 and 2024, with clinical, echocardiographic, and electrocardiographic follow-up. RESULTS: Closure was successful in 110 patients (93%). Failures were due to multifenestrated anatomy, embolization, residual shunt, atrioventricular (AV) block, tricuspid regurgitation, or insufficient aortic rim. Major complications occurred in six patients, including device embolization, progressive aortic regurgitation requiring surgery, persistent nodal rhythm requiring device removal, ventricular perforation, infective endocarditis, and subarachnoid hemorrhage. Minor complications included mild to moderate tricuspid regurgitation (n = 4) and mild aortic regurgitation (n = 5). Arrhythmic events comprised supraventricular tachycardia (n = 2, both resolved), nodal rhythm (n = 1, transient), right bundle branch block (n = 5, persistent in four), and left bundle branch block (n = 1, resolved). Residual shunt was present in 36.4% immediately, declining to 9.8% at follow-up. Larger VSD diameter (OR 1.75, 95% CI 1.14-2.69) and higher body weight (OR 1.07, 95% CI 1.00-1.15) were independent predictors. No late complete AV block, endocarditis, or embolization occurred. Patients treated with Konar-MF were younger and lighter, while Nit-Occlud was associated with higher residual shunt rates (85.7% vs. 33.0%, p = 0.010). CONCLUSION: Transcatheter VSD closure in children demonstrated high success, acceptable complication rates, and favorable long-term outcomes. Results were influenced by device choice, defect size, and patient characteristics, highlighting the need for individualized strategies and continued surveillance.
Vuran et al. (Mon,) conducted a cohort in Ventricular septal defect (n=118). Transcatheter VSD closure was evaluated on Procedural success. Transcatheter VSD closure in children achieved a 93% procedural success rate, with Nit-Occlud devices associated with higher residual shunt rates than other occluders (85.7% vs. 33.0%, p=0.010).
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