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Updated: Mar 22, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Medium to long-term echo follow-up after ventricular septal defect device closure
Muhammed Riyas K Rahmath1, Mohammed Numan2, Muhammad Dilawar3
1Division of Pediatric Cardiac Surgery, Hamad General Hospital, Doha, Qatar.
Insights
Percutaneous closure of ventricular septal defects using Amplatzer devices is effective, with a 91% success rate. Long-term echocardiographic follow-up is crucial for monitoring potential device-related aortic and tricuspid valve regurgitation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Ventricular septal defects (VSDs) are common congenital heart abnormalities.
- Transcatheter closure offers an alternative to surgical repair for VSDs.
- Amplatzer devices are frequently used for percutaneous VSD closure.
Purpose of the Study:
- To evaluate the medium to long-term echocardiographic outcomes of perimembranous and muscular VSD closure using Amplatzer devices.
- To assess the efficacy and safety of transcatheter VSD closure.
- To identify potential device-related complications.
Main Methods:
- Retrospective analysis of 49 patients undergoing percutaneous VSD closure with Amplatzer devices.
- Detailed echocardiographic assessment including transthoracic and transesophageal views.
- Follow-up duration averaged 54.5 months.
Main Results:
- Successful closure achieved in 45/49 patients (91.84% success rate).
- Complete closure observed in 91% of patients at follow-up; 9% had tiny residual defects.
- Mild aortic regurgitation developed in 13.3% and tricuspid regurgitation in 29% of patients.
Conclusions:
- Transcatheter closure of perimembranous and muscular VSDs with Amplatzer devices is an effective procedure.
- Regular echocardiographic follow-up is essential to monitor for device-related complications, particularly valvular regurgitation.
- Long-term surveillance is recommended for patients undergoing percutaneous VSD closure.
Objective:
We aimed to assess the medium to long-term results of echocardiographic follow-up of perimembranous and muscular ventricular septal defect closure with various Amplatzer devices.
Methods:
We successfully closed ventricular septal defects percutaneously in 45/49 patients. There were 35 perimembranous and 10 muscular ventricular septal defects. The median age and weight was 8.50 years (range 2-36.70 years) and 24 kg (range 10-106 kg), respectively. The median size of the ventricular septal defect was 7 mm (range 3-14 mm) on transthoracic echocardiography, 6 mm (range 4-15 mm) on transesophageal echocardiography, and 6 mm (range 3-14 mm) on left ventricular angiography. The median pulmonary-to-systemic blood flow ratio was 1.40 (range 1.0-3.0).
Results:
In the 49 attempted cases, the procedure was successful in 45, with a success rate of 91.84%. At a mean follow-up of 54.50 months, echocardiography showed complete closure in 41 (91%) patients and 4 (9%) had a tiny (1-2 mm) residual defect. New-onset aortic regurgitation was seen in 6 (13.3%) patients at 54.50 months, but it was mild in nature. Tricuspid valve regurgitation was observed in 13 (29%) patients at 54.50 follow-up, of whom 10 (22%) had mild and 3 (7%) had moderate regurgitation.
Conclusion:
Transcatheter closure of perimembranous and muscular ventricular septal defects is effective, however, these patients need to be followed up regularly to detect device-related problems, specifically, aortic and tricuspid valve regurgitation.
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