Applied Anatomy of Perimembranous Ventricular Septal Defect for Transcatheter Device Closure

Area of Science:

• Cardiology
• Congenital Heart Disease
• Interventional Cardiology

Background:

• Perimembranous ventricular septal defects (VSDs) are common congenital heart abnormalities.
• Transcatheter device closure is a primary treatment, offering high success and low complication rates.

Purpose of the Study:

• To categorize perimembranous VSDs into distinct morphologic variants.
• To correlate these variants with echocardiographic findings.
• To guide optimal device selection and procedural strategies.

Main Methods:

• Review and categorization of perimembranous VSDs into 7 morphologic types based on anatomical extension.
• Correlation of morphologic types with echocardiographic classifications.
• Analysis of specific VSD types and their associated complications and treatment considerations.

Main Results:

• Seven morphologic variants of perimembranous VSDs are defined (Types 1-7).
• Specific types are associated with unique challenges: Type 2 with aortic valve issues, Type 5 with conduction system proximity, and Types 6/7 with complex extensions.
• Understanding variants aids in selecting appropriate devices and minimizing complications like valve injury or heart block.

Conclusions:

• A detailed morphologic classification of perimembranous VSDs enhances understanding of their anatomical variations.
• Tailoring device selection based on these variants is crucial for successful transcatheter closure.
• This approach optimizes outcomes and reduces complications in treating congenital heart defects.