Medium to long-term echo follow-up after ventricular septal defect device closure

Asian Cardiovasc Thorac Ann. 2016 Jun;24(5):422-7. doi: 10.1177/0218492316645746. Epub 2016 Apr 25.

Abstract

Objective: We aimed to assess the medium to long-term results of echocardiographic follow-up of perimembranous and muscular ventricular septal defect closure with various Amplatzer devices.

Methods: We successfully closed ventricular septal defects percutaneously in 45/49 patients. There were 35 perimembranous and 10 muscular ventricular septal defects. The median age and weight was 8.50 years (range 2-36.70 years) and 24 kg (range 10-106 kg), respectively. The median size of the ventricular septal defect was 7 mm (range 3-14 mm) on transthoracic echocardiography, 6 mm (range 4-15 mm) on transesophageal echocardiography, and 6 mm (range 3-14 mm) on left ventricular angiography. The median pulmonary-to-systemic blood flow ratio was 1.40 (range 1.0-3.0).

Results: In the 49 attempted cases, the procedure was successful in 45, with a success rate of 91.84%. At a mean follow-up of 54.50 months, echocardiography showed complete closure in 41 (91%) patients and 4 (9%) had a tiny (1-2 mm) residual defect. New-onset aortic regurgitation was seen in 6 (13.3%) patients at 54.50 months, but it was mild in nature. Tricuspid valve regurgitation was observed in 13 (29%) patients at 54.50 follow-up, of whom 10 (22%) had mild and 3 (7%) had moderate regurgitation.

Conclusion: Transcatheter closure of perimembranous and muscular ventricular septal defects is effective, however, these patients need to be followed up regularly to detect device-related problems, specifically, aortic and tricuspid valve regurgitation.

Keywords: Aortic valve regurgitation; Device closure; Tricuspid valve regurgitation; Ventricular septal defect.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / etiology
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Child
  • Child, Preschool
  • Echocardiography*
  • Female
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / physiopathology
  • Heart Septal Defects, Ventricular / therapy*
  • Hemodynamics
  • Humans
  • Male
  • Predictive Value of Tests
  • Retrospective Studies
  • Septal Occluder Device*
  • Time Factors
  • Treatment Outcome
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / etiology
  • Young Adult