Analysis Of 76 Cases Of Transcatheter Closure Of Ventricular Septal Defect Treatment

Objective:The study analyze the association between transcatheter closure of ventricular septal defect (VSD) and the type of VSD, to evaluate the clinical safety and efficacy and how to select the suitable device for the aneurysm-like perimembranous ventricular septal defect.Method:We selected 76 cases with VSD at cardiology department, Zhejiang University Second Affiliated hospital. All the operation were performed at the catheterization laboratory from 2004 to 2010. The age ranged from 15 to 67 years (mean 28.12±13.92years), weight ranged from 38 to 78 Kg (mean 56.88±9.41kg). The diameters of VSD measured by transthoracic echocardiography(TTE) were 2.7 to 12 mm(mean 6.18 mm),the distance from the aortic valve were 1.2～5.3mm (mean 2.68 mm). To determine the location of VSD by left ventricular angiography,71 cases were treated by transcatheter occlusion. Left ventricular angiography was performed again to assess the effect of occlusion after the procedure and we continue to monitor the electrocardiogram for seven days. The echocardiography and electrocardiography were scheduled before discharge, and at 1,3,6 months for the follow-up.Results:Implantation of transcatheter devices attempted in 71 patients with congenital ventricular septal defect, procedure were successful in 66 cases(92.96%) except for 5 failure cases. The success rate of KirklinⅡ-type VSD closure was 95.45%.56 cases (73.68%)with aneurysmal perimembranous ventricular septal defect were performed successfully. The minor complications include transient atrioventricular block(3 cases), left anterior branch block (2 cases), right bundle branch block(2 cases), and mild aortic regurgitation(1 cases),headache (1 cases). No hemolysis, thrombosis, devices displacement and other major complications were found in our study.Conclusions:Our primary study indicated that transcatheter closure can offer the good prognosis to congential VSD with minor complications. The key elements include indication, suitable devices, skilled cardiologist and full-facilitated catheterization laboratory.