Related Experiment Video
Updated: Aug 20, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
[Transcatheter closure of perimembranous ventricular septal defects: a clinical application in children]
Hai-bo Hu1, Shi-liang Jiang, Zhong-ying Xu
1Department of Radiology, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
Insights
Transcatheter closure of perimembranous ventricular septal defects (VSD) is safe and effective in children. This minimally invasive procedure shows promising short-term results for VSD treatment.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Interventional Cardiology
Context:
- Perimembranous ventricular septal defects (VSD) are common congenital heart abnormalities in children.
- Surgical repair of VSD can be associated with significant morbidity.
- Transcatheter closure offers a less invasive alternative for VSD management.
Purpose:
- To evaluate the safety and efficacy of transcatheter closure of perimembranous VSD in pediatric patients.
- To assess the procedural success rate and short-term outcomes of this technique.
- To determine the impact of transcatheter VSD closure on cardiac dimensions.
Summary:
- Fifty children with perimembranous VSD underwent transcatheter closure using an Amplatzer occluder.
- The procedure had a high success rate (94%), with minimal residual shunting and few complications.
- Significant reduction in left ventricle end-diastolic dimension was observed post-closure.
Impact:
- Transcatheter closure is a safe and effective option for pediatric perimembranous VSD.
- This approach demonstrates favorable short-term clinical and echocardiographic outcomes.
- Further long-term studies are warranted to confirm sustained efficacy and safety.
Objective:
To evaluate the safety and efficacy of transcatheter closure of perimembranous ventricular septal defects (TCVSD) in children.
Methods:
From November 2002 to July 2004, fifty children (26 males and 24 females) with perimembranous (ventricular septal defect, VSD) underwent an attempt of transcatheter closure using the amplatzer occluder specially designed for perimembranous VSD. Among the 50 children, one of them was diagnosed with aneurysm of aortic sinus, one with dextrocardia, and two with leakage after the surgical repair of VSD. The mean age of patients was (9.1 +/- 4.8) years (ranged from 2 to 17 years). The mean body weight of patients was (33.5 +/- 19.7) kg (ranged from 9 to 81 kg). The mean diameter of VSD measured by transthoracic echocardiography (TTE) was (4.8 +/- 0.9) mm (ranged from 3 to 7 mm). The mean rate of quantity of pulmonary flow/quantity of systemic flow (Qp/Qs) was 1.3 +/- 0.3 (ranged from 1.1 to 2.0), the moderate shunt from left to right was found in 4 patients and the small shunt from left to right in the rest. Occluder was released through the right heart system. All patients were followed up in 1, 3, 6 and 12 months after procedures of TTE, X-ray and electrocardiography.
Results:
The devices were deployed successfully in 47 patients, the rate of success was 94%. There was a tiny (< 3 mm) residual shunt in 2 patients after closure. During the follow-up of 6 months, only one patient had a tiny residual shunt. Complete left bundle branch block (LBBB) was found in one child who was examined with electrocardiograph 2 weeks later. There was no other severe complication. After 1 to 18 months (mean 7 months) follow-up, all patients demonstrated a great decrease (from 38.5 +/- 4.6 mm pre-closure to 35.2 +/- 5.1 mm post-closure) in their left ventricle end-diastolic dimension (LVEDD, P < 0.05).
Conclusion:
This study demonstrated that transcatheter closure of membranous VSD using occluder would be safe and effective for children, and the results of short-term was satisfied. Further clinical trials are underway to assess the long-term result.
