Fate of Residual Patch Leak After Surgical Closure of Congenital Perimembranous Ventricular Septal Defects
Related Experiment Video
Updated: Jun 29, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Hani N Mufti1,2,3, Ysmeen T Bucklain4, Abdulaziz M Shaheen5
1Department of Cardiac Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Insights
Small residual ventricular septal defect (VSD) patch leaks after surgery are generally benign. These leaks typically resolve or decrease significantly within a year, showing no adverse effects on heart valve function or patient weight gain.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Echocardiography
Background:
- Ventricular septal defects (VSDs) are common congenital heart defects.
- Surgical closure of moderate to large VSDs with patch material is standard treatment.
- Evaluating residual VSD (rVSD) patch leaks and their impact is crucial.
Purpose of the Study:
- To assess the fate of VSD patch leaks one year post-surgery.
- To determine the impact of rVSD patch leaks on aortic and tricuspid valve regurgitation.
Main Methods:
- Retrospective review of 71 patients with perimembranous VSD undergoing surgical closure (Jan 2016 - July 2021).
- Echocardiographic analysis at discharge, 6, and 12 months post-surgery.
- Comparison of rVSD patch leak and valve regurgitation grades with preoperative data.
Main Results:
- No reintervention was required; one early mortality occurred.
- At discharge, 34.3% had a 1-2 mm rVSD leak, and 5.7% had a 2-3 mm leak.
- By 12 months, 95.7% had no rVSD leak; valve regurgitation significantly improved.
Conclusions:
- A residual VSD patch leak of 2 mm or less is benign.
- Small leaks do not impact tricuspid/aortic valve function or weight gain.
- rVSD patch leaks typically decrease in severity or resolve within one year.
Abstract:
IntroductionVentricular septal defects (VSDs) account for 50% of congenital heart defects in children. Surgical closure of moderate to large VSDs using patch material is considered the standard treatment in children to prevent future complications.ObjectivesWe evaluated the fate of VSD patch leak and its impact on aortic and tricuspid valve regurgitation at one year after surgery.MethodsThis retrospective study consisted of patients with a perimembranous VSD who underwent surgery between January 2016 and July 2021. Demographic, echocardiographic, clinical, and operative data were retrospectively reviewed. All patients' echocardiographic images were analyzed at discharge, 6, and 12 months after surgery. Echocardiography assessment focused on the degree of residual VSD (rVSD) patch leak and aortic and tricuspid regurgitation grade compared with preoperative echocardiography.ResultsSeventy-one consecutive patients who underwent perimembranous VSD surgical closure were reviewed. No patient required reintervention. There was one early mortality during follow-up. Of the 70 patients with complete follow-up, 24 patients (34.33%) had a 1-2 mm rVSD patch leak and 4 patients (5.7%) had a 2-3 mm rVSD patch leak at the time of discharge. At 12-month follow-up echocardiography, 67 patients (95.7%) had no rVSD patch leak. Aortic and tricuspid valve regurgitation significantly improved from discharge to 12 months after surgery. The size of the patch leak did not affect patients' weight gain (P ≥ .05).ConclusionsWe demonstrated that a 2 mm or less rVSD patch leak is benign, has no impact on tricuspid or aortic valve function, no impact on weight gain, and almost always decreases in severity or disappears.
