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Updated: May 5, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Risk Factors and Long-Term Outcomes of Tricuspid Regurgitation After Transcatheter Closure of Pediatric

Diandong Jiang1,2, Yingchun Yi2, Lijian Zhao2

  • 1College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics Fujian Medical University Fuzhou China.

Journal of the American Heart Association
|March 7, 2025
PubMed

Insights

Transcatheter closure of perimembranous ventricular septal defects can cause tricuspid regurgitation (TR) in children. Careful device selection is key, as a larger device size relative to body weight increases TR risk, though most cases improve over time.

Area of Science:

  • Pediatric Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Transcatheter closure of perimembranous ventricular septal defects (VSDs) is a common pediatric procedure.
  • Tricuspid regurgitation (TR) is a known complication, but its risk factors and long-term outcomes require further investigation.

Purpose of the Study:

  • To identify risk factors for tricuspid regurgitation (TR) after transcatheter perimembranous VSD closure in children.
  • To evaluate the long-term outcomes of TR in this patient population.

Main Methods:

  • Retrospective analysis of 1343 pediatric patients undergoing transcatheter perimembranous VSD closure (2002-2022).
  • Echocardiographic assessment of TR, with multivariate logistic regression to determine risk factors.
  • Median follow-up of 78 months.

Main Results:

  • Postprocedural TR occurred in 12.1% of patients (new-onset or progression).
  • A higher right disc diameter-to-body weight ratio was an independent risk factor for TR (OR, 2.816).
  • Most TR cases were mild (86.5%) and improved or resolved (71.8%) during follow-up; severe TR requiring surgery was rare.

Conclusions:

  • TR following perimembranous VSD closure is common but usually mild and transient.
  • Device sizing, specifically the right disc diameter relative to body weight, is critical to minimize TR risk.
  • Long-term monitoring is essential for detecting potential late TR progression.
Abstract

Keywords:
long‐term outcomesrisk factorstranscatheter closuretricuspid regurgitationventricular septal defect

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