Surgical treatment of severe complications caused by transcatheter closure of ventricular septal defects

The objective was to report the surgical results following failed transcatheter intervention for closure of ventricular septal defects (VSDs). This study is a retrospective analysis of patients (n = 9) from Xijing Hospital (Xi'an, China) with failed transcatheter intervention for VSDs who subsequently underwent open heart surgery. Five patients experienced complications during transcatheter intervention, including third-degree atrioventricular block (III° AVB) (n = 2), aortic incompetence (n = 2), or tricuspid incompetence (n = 1). The devices were immediately removed in the catheterization laboratory followed by open heart surgery to repair VSDs. Four patients experienced complications after transcatheter intervention; one patient's device was displaced into the right ventricle, and 3 patients had III° AVB. These patients underwent surgery to retrieve the devices and to repair VSDs. All cardiac surgery was performed under general anesthesia and under cardiopulmonary bypass. Postoperatively, all patients recovered uneventfully with no deaths or complications. The patients with III° AVB after device implantation recovered sinus rhythm postoperatively, and tricuspid apparatus injuries were surgically repaired with valvuloplasty. Transcatheter interventional VSD closure is safe and effective, but only under the conditions of strict patient selection, proper technique, and device application. Once severe complications are observed and diagnosed, devices should be retrieved immediately, and open heart surgery should be performed to avoid further injury.