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Experience of Percutaneous Closure of Ventricular Septal Defects in 140 Patients With Different Duct Occluders in a
Benumadhab Ghosh1, Isha Sahai1, Gajendra Agrawal1
1Cardiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Insights
Duct occluders offer a safe and effective minimally invasive treatment for Ventricular Septal Defects (VSDs), with a high success rate and low complication risk. This approach is financially beneficial for patients requiring VSD closure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Pediatric Cardiology
Background:
- Ventricular Septal Defects (VSDs) are common congenital heart abnormalities in infants.
- Minimally invasive procedures are increasingly utilized for VSD management.
- This study evaluates the use of duct occluders for VSD closure in rural India.
Purpose of the Study:
- To assess the success and complication rates of transcatheter VSD closure using duct occluders.
- To evaluate the safety and efficacy of this technique in perimembranous and muscular VSDs.
- To analyze the relationship between VSD closure outcomes and patient/device factors.
Main Methods:
- Retrospective study of patients undergoing percutaneous VSD closure between July 2017 and December 2020.
- Review of medical records for pre- and post-procedure imaging, clinical, and interventional data.
- Analysis of outcomes based on patient demographics, VSD type, and device type.
Main Results:
- A high VSD closure success rate of 98.6% was achieved.
- Overall complication rate was low at 1.4%, with no mortality.
- Muscular VSDs showed a higher complication rate (14.3%) compared to perimembranous VSDs.
Conclusions:
- Percutaneous VSD closure using duct occluders demonstrates excellent safety and efficacy with low morbidity.
- Device type did not correlate with device failure, suggesting duct occluders are a cost-effective option.
- This approach offers a financially advantageous alternative for VSD closure in selected patients.
Abstract:
Background Ventricular septal defects (VSDs) are the most common type of septal defects in early infants and are very complicated. This has paved the way for the development of new minimally invasive procedures for interventional cardiologists. This study presents our experience using duct occluders instead of conventional ventricular septal devices in the Department of Cardiology at Acharya Vinoba Bhave Rural Hospital (AVBRH) in central rural India. This study aimed to review success and complications and assess safety and its relation to age, sex, size of the VSDs, type of VSD, and types of devices used after transcatheter closure of perimembranous and muscular VSDs using various types of duct occluders. Methodology This retrospective study included patients who underwent percutaneous VSD device closure at the AVBRH between July 2017 and December 2020. We reviewed the patients' medical records to recognize imaging, clinical, and interventional data pre- and post-procedure and at the last follow-up. Results The success rate of VSD closure was 98.6%, one (0.7%) out of 81 females developed a complication due to device dislodgement, and one male aged six years (0.7%) out of 59 developed a post-procedural complication; hence, the total failure rate was 1.4%. The perimembranous type had no complication, and the muscular type had two (14.3%) unsuccessful procedures. Conclusion This study has concluded an impressive percentage of VSD closure, showing no mortality and low morbidity, using a percutaneous approach with different duct occluders. As the type of device used is not correlated with device failure and failure rate, duct occluders will be financially helpful in the closure of VSD in indicated patients.
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