The Short and Midterm Follow-Up of Transthoracic Device Closure of Perimembranous Ventricular Septal Defect in Adults
Keywords:CHD, septal defects, cardiac intervention, transthoracic, surgery
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.
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.
How to Cite
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).