Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up
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RESEARCH ARTICLE
Open Access
Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up Long Wang, Lin Xie, Weiqiang Ruan, Tao Li, Changping Gan and Ke Lin*
Abstract Background: This report presents updated data and mid-term follow-up information to a former study introducing the novel technique of percutaneous-perventricular device closure of doubly committed subarterial ventricular septal defect. Methods: Thirty-eight patients were added to the former series. There were 54 patients in total who had isolated doubly committed subarterial ventricular septal defects and underwent percutaneous-perventricular device closure. Closure outcomes and possible complications were measured in the hospital and during the 2.5-year follow-up. Results: Surgery was successful in 53 patients (98.1%). There was no death, residual shunt, new valve regurgitation or arrhythmia either perioperatively or during the entire follow-up period. Only one patient developed pericardial effusion and tamponade in the former series. The mean hospital stay was 3.2 ± 0.6 days (range, 3.0 to 6.0 days), and only one unsuccessful case needed blood transfusion (1.9%). Conclusions: The percutaneous-perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be safe. Close monitoring for bleeding is essential postoperatively, especially in younger patients. This technique is generally safe with acceptable mid-term follow-up. Keywords: Ventricular septal defect, Minimally invasive surgery
Background Doubly committed subarterial ventricular septal defect (VSD) is a unique type of VSD accounting for about 5–7% of all VSDs [1], which has been a contraindication for percutaneous transcatheter device closure due to the challenging geometry consisting of the upper edge of the defect and the aortic valve. Perventricular device closure of VSD without cardiopulmonary bypass (CPB) under transesophageal echocardiography (TEE) guidance has been widely practiced in China [2, 3], and was also used in some cases in Europe [4]. This technique has also been introduced * Correspondence: [email protected] Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No.37 Guoxue Lane, Wuhou District, Chengdu, Sichuan 610041, People’s Republic of China
recently in the treatment of doubly committed subarterial VSD with encouraging initial results and excellent cosmetic outcome [5–7]. Compared to a mini-thoracotomy, we have advanced a novel and more minimally invasive method by combining perventricular device closure with the percutaneous approach [8]. We successfully closed doubly committed subarterial VSDs through a pinholesize puncture on the chest. The short-term result has been introduced elsewhere [8], and we present an update of the patient series and its mid-term follow-up result.
Methods In our previous report [8], patients were enrolled from January to May 2015, 16 patients (9 male) were included; In this update, from January 2015 to January 2019,
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