Medium to long-term echo follow-up after ventricular septal defect device closure

Abstract

Objective

We aimed to assess the medium to long-term results of echocardiographic follow-up of perimembranous and muscular ventricular septal defect closure with various Amplatzer devices.

Methods

We successfully closed ventricular septal defects percutaneously in 45/49 patients. There were 35 perimembranous and 10 muscular ventricular septal defects. The median age and weight was 8.50 years (range 2–36.70 years) and 24 kg (range 10–106 kg), respectively. The median size of the ventricular septal defect was 7 mm (range 3–14 mm) on transthoracic echocardiography, 6 mm (range 4–15 mm) on transesophageal echocardiography, and 6 mm (range 3–14 mm) on left ventricular angiography. The median pulmonary-to-systemic blood flow ratio was 1.40 (range 1.0–3.0).

Results

In the 49 attempted cases, the procedure was successful in 45, with a success rate of 91.84%. At a mean follow-up of 54.50 months, echocardiography showed complete closure in 41 (91%) patients and 4 (9%) had a tiny (1–2 mm) residual defect. New-onset aortic regurgitation was seen in 6 (13.3%) patients at 54.50 months, but it was mild in nature. Tricuspid valve regurgitation was observed in 13 (29%) patients at 54.50 follow-up, of whom 10 (22%) had mild and 3 (7%) had moderate regurgitation.

Conclusion

Transcatheter closure of perimembranous and muscular ventricular septal defects is effective, however, these patients need to be followed up regularly to detect device-related problems, specifically, aortic and tricuspid valve regurgitation.