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Left-to-right shunting in common congenital heart defects: which patients are eligible for percutaneous
Werner Budts1, Marc Gewillig, Frans Van de Werf
1Division of Cardiology and Congenital Cardiology, UZ Leuven, Belgium. Werner.Budts@uz.kuleuven.ac.be
Insights
Minimally invasive percutaneous closure is now available for common congenital heart defects like atrial and ventricular septal defects, offering a less painful and shorter hospital stay compared to traditional surgery.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Congenital heart defects such as atrial septal defects, atrioventricular septal defects, ventricular septal defects, and patent ductus arteriosus can lead to significant left-to-right shunting.
- Chronic volume overload from these defects can cause pulmonary arterial hypertension and potentially lead to Eisenmenger syndrome.
Purpose of the Study:
- To review the current status and benefits of percutaneous closure techniques for congenital heart defects.
- To highlight the advantages of percutaneous closure over traditional surgical methods.
Main Methods:
- Review of current literature on percutaneous closure of congenital heart defects.
- Comparison of outcomes, patient tolerance, and hospital stay between percutaneous and surgical interventions.
Main Results:
- Percutaneous closure is now feasible for patent ductus arteriosus, secundum atrial septal defects, and increasingly for muscular and perimembranous ventricular septal defects.
- Percutaneous techniques significantly reduce post-procedural pain and shorten hospitalisation duration compared to surgery.
- Favorable economic aspects are associated with percutaneous closure methods.
Conclusions:
- Percutaneous closure offers a well-tolerated and effective alternative to surgery for specific congenital heart defects.
- These minimally invasive techniques improve patient recovery and potentially reduce healthcare costs.
- Continued development in percutaneous closure broadens treatment options for congenital heart disease.
Abstract:
Atrial septal defects, atrio-ventricular septal defects, ventricular septal defects and the persistent arterial duct are the most common congenital heart defects which may cause, in the presence of a significant left-to-right shunt, chronic volume overload of the heart and lead to the development of pulmonary arterial hypertension. Repair is indicated to avoid these complications and evolution to right-to-left shunting (Eisenmenger syndrome). Although the long-term results of surgical interventions in uncomplicated congenital heart defects were excellent, percutaneous techniques to repair the defects became a focus of attention. The persistent arterial duct, the secundum type atrial septal defect, and, more recently, the muscular and perimembranous ventricular septal defect are currently eligible for percutaneous closure. By avoiding a sternotomy or a thoracotomy, complaints of pain become exceptional and the duration of hospitalisation is shortened. Percutaneous closure is not only better tolerated than surgery, it may also imply favourable economical aspects.