Abstract:

Objective  To evaluate the therapeutic effect of transcatheter closure of ventricular septal defect(VSD). Methods  During 2005 to 2007, a total of 90 cases diagnosed as congenital VSD were admitted to our department, of  which 86 cases underwent transcatheter closure succesessfully. The clinical data including electrocardiogram and transthoratic echocardiography before and after intervention, angiogram during intervention, implanted occluder devices and followup data of all patients were analysed. Results  Among the 90 patients, 40 were male and 50 were female, aged from 2  to 34 years  (mean age, 8.9 years). 87 had perimembranous ventricular septal defect, 3  intercristal ventricular septal defect, 1 residual fistula after surgery repair and 1 patent ductus arteriosus. 86 cases (95.6%) were occluded successfully. The VSD diameter was 1.58.8mm. The implanted occluder device diameter was 4-18mm. Amplatzer membranous VSD occluder were used in 17 cases,  home-made thin-waist-big-side occluder in 13 cases, home-made concentric occluder in 52 cases and home-made eccentric occluder in 2 cases. The average follow-up time was 18 months. 30 cases presented various complications including 3 cases of CRBBB, 2 case of ICRBBB, 6 cases of accelerated junctional tachycardia, which were all transient, disappearing after 1 week-3months. Residual shunt occured in 3 cases,  and 1 case had mechanical hemolysis, which resolved 7 days later after conservative therapy. Aortic valve regur-gitation occurred in 2 cases and tricuspid regurgitation occurred in 3 cases. All the regurgitation was mild to moderate and no further treatment were performed. Conclusions  Transcatheter closure of perimembraneous VSD is safe and efficacious, and the successful rate is high with rare severe complications. Conduction blockades are the main complications. It is important to be diagnosed and treated in time. Further followup studies are required to document the longterm effect on the intracardiac condution.

Key words: Ventricular septal defect; Transcatheter closure; Complications; Follow-up