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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Complete heart block after occlusion and repair for perimembranous ventricular septal defect

Li Lin1, Wanhua Chen1, Hang Chen1

  • 1Department of Cardiology, Heart Center of Fujian Province, Fujian Medical University Union Hospital, Fuzhou, Fujian, P. R. China.

Acta Cardiologica
|March 31, 2025
PubMed

Insights

Device closure of perimembranous ventricular septal defects (pmVSDs) carries a higher risk of complete atrioventricular conduction block (CAVB) compared to surgical repair. Large VSD size and device/defect ratio are key risk factors for CAVB in pmVSD treatment.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Medical Device Technology

Background:

  • Complete atrioventricular conduction block (CAVB) is a significant complication following interventions for perimembranous ventricular septal defects (pmVSDs).
  • Understanding the incidence and risk factors of CAVB is crucial for improving patient outcomes after pmVSD repair and occlusion.

Purpose of the Study:

  • To analyze the incidence of CAVB after pmVSD occlusion and repair.
  • To identify risk factors associated with CAVB in patients undergoing pmVSD closure.

Main Methods:

  • Retrospective review of patients who underwent pmVSD occlusion or repair between January 2010 and January 2022.
  • Definition of permanent CAVB as requiring pacemaker implantation or occluder extraction.
  • Multivariate regression analysis to identify independent risk factors.

Main Results:

  • The incidence of permanent CAVB was 0.7% for device occlusion and 0.3% for surgical repair.
  • Large pmVSD size and device/defect ratio were independent risk factors for CAVB in respective treatment groups.
  • Device occlusion was associated with a significantly higher risk of permanent CAVB compared to surgical repair (OR, 4.675).

Conclusions:

  • Device occlusion for pmVSDs presents a higher risk of permanent CAVB than surgical repair.
  • Strategies to mitigate CAVB risk in pmVSD closure should consider VSD size and device selection.
Abstract

Keywords:
Perimembranous ventricular septal defectscomplete atrioventricular blockdevice occlusionsurgical repair

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