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Transcatheter Closure of Perimembranous Ventricular Septal Defects in Children using a Wire-Drifting Technique

Lu He1, Ge-Sheng Cheng1, Yu-Shun Zhang1

  • 1Department of Structural Heart Disease, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi Province, China.

Clinics (Sao Paulo, Brazil)
|December 6, 2018
PubMed

Insights

Transcatheter closure of perimembranous ventricular septal defects using the wire-drifting technique (WT) is a safe and effective option for children. This method demonstrated comparable success rates to the conventional technique (CT) with a lower incidence of atrioventricular block.

Area of Science:

  • Interventional Cardiology
  • Pediatric Cardiac Surgery
  • Congenital Heart Disease Treatment

Background:

  • Perimembranous ventricular septal defects (pmVSD) are common congenital heart abnormalities in children.
  • Transcatheter closure offers a less invasive alternative to surgical repair for pmVSD.
  • The wire-drifting technique (WT) is a novel approach for establishing arteriovenous loops during transcatheter procedures.

Purpose of the Study:

  • To evaluate the feasibility and safety of transcatheter closure of pediatric pmVSD using the WT.
  • To compare the outcomes of WT with the conventional technique (CT) for pmVSD closure.

Main Methods:

  • Retrospective analysis of 121 pediatric patients with pmVSD treated between December 2011 and December 2014.
  • Patients were divided into a conventional technique (CT) group and a wire-drifting technique (WT) group based on arteriovenous loop establishment.
  • Procedural success, complication rates, and 2-year follow-up data were analyzed.

Main Results:

  • Procedural success rates were high and comparable between groups (96.2% in CT vs. 97.1% in WT).
  • The WT group showed a lower incidence of atrioventricular block (1.5% vs. 5.7% in CT) and no cases of intraprocedural block.
  • No significant difference in procedure time or residual shunting was observed; aggravated tricuspid regurgitation was only seen in the CT group.

Conclusions:

  • Transcatheter closure of pediatric pmVSD using the WT is a safe and effective alternative to the CT.
  • The WT technique may offer a reduced risk of atrioventricular block and tricuspid regurgitation compared to the conventional method.
Abstract

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