Efficacy and safety of the Amplatzer Duct Occluder II for ventricular septal defect closure: a meta-analysis

Transcatheter closure has become an effective and safe method to repair ventricular septal defects (VSDs). However, the devices used for VSD closure in the past frequently led to serious complications, such as complete atrioventricular block. The second‑generation device, the Amplatzer Duct Occluder (ADO II), was originally designed to block small‑ and medium‑sized patent ductus arteriosus. Interestingly, there are some reports of the use of the ADO II to close VSD because of less complications.

A meta‑analysis of the literature was performed to systematically investigate the efficacy and safety of the ADO II for VSD closure.

The Embase, PubMed, Cochrane, and Web of Science databases were searched for original studies on VSD closure with the ADO II up to March 15, 2020. The random‑effects model and summary rate were employed to estimate the success and complications of VSD closure with the ADO II.

A total of 13 articles comprising 478 patients with VSD were included. The age of the patients ranged from 0.5 to 55.7 years. The overall estimated device‑implantation success rate was 99% (95% CI, 98%-100%). Residual shunts (pooled rate, 4%; 95% CI, 1%-7%) and postoperative aortic valve regurgitation (pooled rate, 0%; 95% CI, 0-1%) were common complications. Only 3 patients developed device embolism.

The ADO II may be a safer and more effective transcatheter closure device for patients with VSD due to its higher success rate and lower complication rate, as compared with other devices.