The Short and Midterm Follow-Up of Transthoracic Device Closure of Perimembranous Ventricular Septal Defect in Adults

  • Ze-wei Lin Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Qiang Chen Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Hua Cao Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Gui-can Zhang Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Liang-wan Chen Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Qi-liang Zhang Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
  • Zhi-nuan Hong Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P. R. China
Keywords: CHD, septal defects, cardiac intervention, transthoracic, surgery

Abstract

Background: The purpose of this study was to assess the short- and mid-term follow-up results of transthoracic device closure of perimembranous ventricular septal defect (pmVSD) in adults.

Methods: Sixty-one adults underwent transthoracic device closure of pmVSD at our institution from Jan. 2012 to Jan. 2016. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography (TTE) for 12 months to 60 months after VSD closure. Phone interviews were conducted to further evaluate the cardiac function status.

Results: All patients were successfully occluded using this procedure. The most frequent complication was transient cardiac arrhythmia, which was easily treated during the perioperative period. During the follow-up period, we found no recurrence, malignant arrhythmia, thrombosis, device embolization, valve damage, device failure, or cases of death. The total occlusion rate was 100 percent in the 12 months of follow-up, and most of patients showed significant improvement in their clinical status. From the TTE data, the intracardiac structure and cardiac function were improved in the follow-up.

Conclusion: Transthoracic device closure of perimembranous ventricular septal defect in adults is a safe and feasible technique. The short- and mid-term follow-up results were satisfactory, but long-term follow-up is required to better assess the safety and feasibility of this method in adults.

References

Amin Z, Danford DA, Lof J, Duncan KF, Froemming S. 2004. Intraoperative device closure of perimembranous ventricular septal defects without cardiopulmonary bypass: preliminary results with the perventricular technique. J Thorac Cardiovasc Surg 127(1):234-41.

Bass JL, Kalra GS, Arora R, Masura J, Gavora P, Thanopoulos BD, Torres W, Sievert H, Carminati M, Fischer G, Ewert P. 2003. Initial human experience with the Amplatzer perimembranous ventricular septal occluder device. Catheter Cardiovasc Interv 58(2):238-45.

Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG, et al. 2007. Transcatheter closure of perimembranous ventricular septal defects: early and long-term results. J Am Coll Cardiol 50:1189-95.

Butera G, Massimo C, Mario C. 2006. Late complete atriovenous block after percutaneous closure of a perimembranous ventricular septal defect. Catheter Cardiovasc Interv 67(6):938-41.

Cao H, Chen Q, Zhang GC, Chen LW, Li QZ, Qiu ZH. 2011. Intraoperative device closure of perimembranous ventricular septal defects in the young children under transthoracic echocardiographic guidance; initial experience. J Cardiothorac Surg 6:166.

Carminati M, Butera G, Chessa M, De Giovanni J, Fisher G, Gewillig M, Peuster M, Piechaud JF, Santoro G, Sievert H, Spadoni I, Walsh K. 2007. Investigators of the European VSD Registry.Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J 28(19):2361-8.

Chen Q, Cao H, Zhang GC, Chen LW, Li QZ, Qiu ZH. 2012. Atrioventricular block of intraoperative device closure perimembranous ventricular septal defects; a serious complication. BMC Cardiovasc Disord 12:21.

Chen Q, Cao H, Zhang GC, Chen LW, Li QZ, Qiu ZH. 2013. Closure of perimembranous ventricular septal defects with intraoperative device technique: another safe alternative to surgical repair. Thorac Cardiovasc Surg Jun; 61(4): 293-9.

Chessa M, Butera G, Negura D, Bussadori C, Giamberti A, Fesslova V, Carminati M. 2009. Transcatheter closure of congenital ventricular septal defects in adult: mid-term results and complications. Int J Cardiol 133(1):70-3.

Ergene O, Kahya Eren N, Nazlı C, Duygu H, Kocabaş U. 2015. Percutaneous closure of perimembranous ventricular septal defects associated with septal aneurysm in adults. Turk Kardiyol Dern Ars 43(8):699-704.

Gan C, An Q, Lin K, Tang H, Lui RC, Tao K, Pan W, Shi Y. 2008. Perventricular device closure of ventricular septal defects: six months results in 30 young children. Ann Thorac Surg 86(1):142-6.

Masura J, Gao W, Gavora P, Sun K, Zhou AQ, Jiang S, Ting-Liang L, Wang Y. 2005. Percutaneous closure of perimembranous ventricular septal defects with the eccentric Amplatzer device: multicenter follow-up study. Pediatr Cardiol 26(3):216-9.

Quansheng X, Silin P, Zhongyun Z, Youbao R, Shengde L, Qian C, Shuhua D, Kefeng H, Zhixian J, Qin W. 2009. Minimally invasive perventricular device closure of an isolated perimembranous ventricular septal defect with a newly designed delivery system: preliminary experience. J Thorac Cardiovasc Surg 137 (3):556-9.

Tao K, Lin K, Shi Y, Song H, Lui RC, Gan C, An Q. 2010. Perventricular device closure of perimembranous ventricular septal defects in 61 young children: early and midterm follow-up results. J Thorac Cardiovasc Surg 140 (4): 864-70.

Tucker EM, Pyles LA, Bass JL, Moller JH. 2007. Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol 50:1196-200.

Walsh MA, Bialkowski J, Szkutnik M, Pawelec-Wojtalik M, Bobkowski W, Walsh KP. 2006. Atrioventricular block after transcatheter closure of perimembranous ventricular septal defects. Heart 92(9):1295-7.

Xing Q, Pan S, An Q, Zhang Z, Li J, Li F, Wu Q, Zhuang Z. 2010. Minimally invasive perventricular device closure of perimembranous ventriculr septal defect without cardiopulmonary bypass: multicenter experience and mid-term follow-up. J Thorac Cardiovasc Surg 139(6):1409-15.

Yang L, Tai BC, Khin LW, Quek SC. 2014. A systematic review on the efficacy and safety of transcatheter device closure ofventricular septal defects (VSD). J Interv Cardiol Jun;27(3):260-72.

Yang R, Kong XQ, Sheng YH, Zhou L, Xu D, Yong YH, Sun W, Zhang H, Cao KJ. 2012. Risk factors and outcomes of post-procedure heart blocks after transcatheter device closure of perimembranous ventricular septal defect. JACC Cardiovasc Interv 5(4):422-7.

Zeng XJ, Sun SQ, Chen XF, Ma XJ, Luo YH, Lim YP, Tao L. 2008. Device closure of perimembranous ventricular septal defects with a minimally invasive technique in 12 patients. Ann Thorac Surg 85(1):192-4.

Zhou T, Shen XQ, Zhou SH, Fang ZF, Hu XQ, Zhao YS, Qi SS, Zhou Z, Li J, Lv XL. 2008. Atrioventricular block: a serious complication in and after transcatheter closure of perimembranous ventricular septal defects. Clin Cardiol 31(8): 368-71.

Published
2018-06-14
Section
Articles