Percutaneous closure of ventricular septal defects

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Surgical closure of ventricular septal defects (VSDs) is the gold standard but carries risks.
• Transcatheter techniques have emerged as a less invasive alternative over the past decade.
• These minimally invasive methods aim to reduce the morbidity and mortality associated with traditional surgery.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous closure for ventricular septal defects.
• To compare transcatheter closure outcomes with conventional surgical methods.
• To assess the suitability of percutaneous closure for both congenital and acquired VSDs.

Main Methods:

• Procedures performed under general anesthesia with fluoroscopic and transesophageal echocardiographic guidance.
• Utilized Amplatzer family devices for percutaneous closure of muscular and perimembranous VSDs.
• Reviewed literature data on successful closure rates and complication profiles.

Main Results:

• Successful closure rates for muscular and perimembranous VSDs are approximately 96% with ~2% major complications.
• Complete atrioventricular block is the primary concern, occurring in about 1.7% of cases.
• Percutaneous closure for post-myocardial infarction defects shows an 88% success rate but a 22% mortality.

Conclusions:

• Percutaneous VSD closure is safe and effective in experienced hands.
• It serves as a viable alternative to surgery for selected patients with congenital or acquired VSDs.
• Offers a significantly lower rate of mortality and complications compared to surgical intervention.