Key result
Transcatheter closure of VSDs with aortic valve prolapse yields ~89% success, stabilizing long-term valve function.
Why the study?
The morphology and function of the aortic valve after transcatheter closure of VSD with aortic valve prolapse have not been fully evaluated based on clinical and radiological outcomes.
Does transcatheter closure of VSD improve aortic valve morphology and function in patients with VSD and aortic valve prolapse?
Observational (n=164)
No
Does transcatheter closure of VSD improve aortic valve morphology and function in patients with VSD and aortic valve prolapse?
Transcatheter closure of VSD in patients with aortic valve prolapse is feasible and leads to long-term stabilization or improvement of aortic valve function.
Supports transcatheter closure in selected patients; leaves open need for randomized trials to confirm aortic valve benefits.
Objective: This study aims to evaluate the morphology and function of the aortic valve after transcatheter closure of ventricular septal defect (VSD) with aortic valve prolapse (AVP) abased on clinical and radiological outcomes. Methods: From January 2013 to November 2014, 164 consecutive patients (97 males, 59.1%) with VSD and AVP were treated by transcatheter closure. The patients were divided into the mild AVP group (n = 63), moderate AVP group (n = 89) and severe AVP group (n = 12). The clinical and radiological outcomes of these patients were analyzed retrospectively. Results: In total, 146 (89.0%) patients were successfully treated with VSD occluders, including 59/63 (93.7%) with mild AVP, 80/89 (89.9%) with moderate AVP and 7/12 (58.3%) with severe AVP. The degree of AVP was ameliorated or disappeared in 39 (26.7%) patients, and remained unchanged in 103 (70.5%) patients after the intervention. In the 35 patients who initially had trivial-to-moderate aortic regurgitation (AR), the degree of AR was ameliorated or disappeared in 25 (71.4%) patients, aggravated from trivial to mild AR in 1 (2.9%) patient, and remained unchanged in 9 (25.7%) patients. In 111 patients without AR, 1 (0.9%) patient had mild AR and 24 (21.6%) patients had trivial AR after intervention. The depth and width of the prolapsed aortic valve decreased after transcatheter closure of VSD in all three groups. During the 70-month (range, 54–77) follow-up period, no patients with AVP and AR needed an aortic valve intervention. Conclusions: Transcatheter closure of VSD with AVP is feasible. The morphology and function of the prolapsed aortic valve improved and remained stable for a long period after intervention.
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Zhang et al. (2021) conducted an observational in Ventricular septal defect with aortic valve prolapse (n=164). Transcatheter closure of ventricular septal defect was evaluated on Successful transcatheter closure of VSD. Transcatheter closure of ventricular septal defect with aortic valve prolapse was successful in 89.0% of patients, leading to improved or stable aortic valve morphology and function over a median 70-month follow-up.
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