Rapid left ventricular dimension normalization following transcatheter ventricular septal defect closure in children

This study evaluated left ventricular (LV) dimension changes after transcatheter ventricular septal defect (VSD) closure in children and identified factors influencing these changes.

We retrospectively studied 124 children (mean age: 3.5 ± 3.0 years) with preoperative LV Z-scores ≥2 who underwent successful transcatheter VSD closure. LV end-diastolic diameter (LVEDD) Z-scores were assessed using echocardiography at 1, 3, 6, and 12 months postoperatively. Predictors of LV dimension normalization were identified using binary logistic regression.

The mean VSD size was 5.7 ± 2.0 mm. LVEDD Z-scores significantly decreased over time, with 87.1 % of patients achieving normalization at 1 month. The most rapid change occurred in the first postoperative month (64 % decrease). Age showed an inverse association (OR 0.41, p = 0.036) and VSD size a positive association (OR 1.53, p = 0.007) with LVEDD Z-score normalization at 1 month. Device-specific complications, including conduction disturbances, occurred more frequently with non-symmetric occluders (13.0 %) than with perimembranous symmetric occluders (3.0 %) (p = 0.077). Although complications delayed recovery, normalization was achieved by 12 months in nearly all cases.

Transcatheter VSD closure results in rapid normalization of LV dimensions in children, with the most significant changes occurring in the first postoperative month. The identified associations of age and VSD size with LV dimension improvement support transcatheter VSD closure as an effective treatment for hemodynamically significant VSDs in children.