Transcatheter closure of perimembranous ventricular septal defect using a modified double-disk occluder

This multicenter study assessed the efficacy and safety of transcatheter closure of perimembranous ventricular septal defect (VSD) using a modified double-disk occluder. In 5 different centers in China, 412 patients with VSD, including 202 men and 210 women, underwent attempted transcatheter closure. The age range was 3 to 65 years (mean 16.4+/-9.1). The diameter of defect was 3 to 15 mm by transthoracic echocardiography and 3 to 18 mm by left ventriculography. The ratio of pulmonary to systemic flow varied from 1.6 to 2.3 (1.9+/-0.4). The device diameter was 4 to 20 mm (7.09+/-3.60). The ventricular septal rim below the aortic valve was 0 to 5 mm. The immediate success rate was 96.6%; 6 cases had third degree atrioventricular block and recovered within 3 weeks. None needed a permanent pacemaker. Dislodgement of the device occurred in 3 patients but the device was recaptured and redeployed in 2 cases. During the follow-up period of 2 years, there was no evidence of residual shunt and device-related complications. In conclusion, transcatheter closure of VSD is safe and effective in most selected patients; the mid-term prognosis of patients with transcatheter closure is good.