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Updated: Dec 7, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter device closure of ventricular septal defects in children: a retrospective study at a single cardiac
Saad Q Khoshhal1, Mansour B Al-Mutairi2, Abdulhameed A Alnajjar2
1From the Department of Pediatrics, Faculty of Medicine, Taibah University, Madinah, Saudi Arabia.
Insights
Transcatheter closure effectively treats pediatric ventricular septal defects (VSDs). This minimally invasive procedure demonstrates high success rates and a low incidence of adverse events in children.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Ventricular septal defect (VSD) is the most prevalent congenital heart anomaly in children.
- Transcatheter closure offers a viable alternative to surgery for specific VSD types.
Purpose of the Study:
- To evaluate the safety, efficacy, and outcomes of percutaneous transcatheter closure for VSDs in pediatric patients.
- To assess the feasibility of this minimally invasive approach for various VSD morphologies.
Main Methods:
- A retrospective, single-center study involving 70 children undergoing transcatheter VSD closure from December 2014 to January 2019.
- Data collected from medical records, including pre- and post-procedure Transthoracic Echocardiography (TTE) and Electrocardiogram (ECG).
- Procedures utilized retrograde or antegrade approaches with Amplatzer devices, followed by structured clinical and TTE follow-up.
Main Results:
- The study included 70 children (mean age 10.2 years), with 68.6% having muscular VSD and 31.4% perimembranous VSD.
- A 90% procedural success rate was observed within 24 hours post-procedure.
- Major adverse events occurred in only 5.7% of cases, including atrioventricular block, hemolysis, and thrombus formation.
Conclusions:
- Percutaneous transcatheter closure is a safe and effective treatment option for pediatric VSDs across different morphologies.
- The procedure is associated with a low rate of adverse events, supporting its role in VSD management.
Background:
Ventricular septal defect (VSD) is the most common congenital heart disease in the pediatric population. Nowadays, trans-catheter closure is considered a feasible method of therapy for most muscular and some perimembranous types of VSDs.
Objective:
Assess the safety, efficacy and outcome of percutaneous transcatheter closure of VSDs in children.
Design:
Retrospective, single center study.
Setting:
Madinah Cardiac Center, Madinah, Saudi Arabia.
Patients And Methods:
The study included all consecutive children who underwent transcatheter closure of isolated VSD during the period from December 2014 to January 2019. The data were collected from hospital database medical records. Transthoracic echocardiography (TTE) and an electrocardiogram (ECG) were done before and after the procedure in all the patients. The device was implanted by the retrograde or antegrade approach. All patients were subjected to follow-up evaluation at 1, 3, 6, 12 months, and annually thereafter with TTE and ECG.
Main Outcome Measures:
Procedure success rate, clinical follow-up, TTE.
Sample Size:
70 children.
Results:
The mean (standard deviation) age of patients was 10.2 (4.1) years (range: 2-18 years), and their mean body weight was 30.9 (13.9) kg (range: 7.0-57.7 kg). Forty-eight (68.6%) children had muscular VSD (mVSD), and 22 (31.4%) children had perimembranous VSD (pmVSD). The majority of defects were closed via the retrograde approach using the Amplatzer muscular occluder device. At 24 hours after the procedure, the success rate was 90%. Only four (5.7%) cases had major adverse events including complete atrioventricular block, hemolysis, and thrombus formation.
Conclusion:
Transcatheter closure is a safe and feasible procedure in VSDs of various morphologies, with a low adverse event rate.
Limitations:
Retrospective design, single-center study, absence of control group.
Conflict Of Interest:
None.
