Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results
Background In children, the practice of transcatheter closure of intracristal ventricular septal defect (icVSD) has been limited. Currently, there is a lack of comparison between device closure of perimembranous ventricular septal defect (pmVSD) and icVSD, and long‐term clinical outcomes are rare. M...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-06-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020417 |
| _version_ | 1818393490314231808 |
|---|---|
| author | Diandong Jiang Bo Han Lijian Zhao Yingchun Yi Jianjun Zhang Youfei Fan Jianli Lv Jing Wang Yan Wang |
| author_facet | Diandong Jiang Bo Han Lijian Zhao Yingchun Yi Jianjun Zhang Youfei Fan Jianli Lv Jing Wang Yan Wang |
| author_sort | Diandong Jiang |
| collection | DOAJ |
| description | Background In children, the practice of transcatheter closure of intracristal ventricular septal defect (icVSD) has been limited. Currently, there is a lack of comparison between device closure of perimembranous ventricular septal defect (pmVSD) and icVSD, and long‐term clinical outcomes are rare. Methods and Results This study included a total of 633 children (39 with icVSD and 594 with pmVSD), aged 18 months to 16 years, who underwent transcatheter closure of ventricular septal defect between January 2014 and December 2018. All patients were followed up until September 2020, with a median follow‐up of 46 months in the pmVSD group and 52 months in the icVSD group. The procedural success rate was 96.3% and 84.6% in pmVSD and icVSD groups, respectively (P=0.002). The median of age, weight, procedure time, fluoroscopic time, and radiation dose were greater in the icVSD group compared with the pmVSD group. More eccentric ventricular septal defect occluders were used in the icVSD group. Most adverse events were minor without any intervention, with cardiac rhythm/conduction abnormalities being the most common. In the pmVSD group, 2 patients experienced complete atrioventricular block, with one implanting a permanent pacemaker and the other dying of cardiac arrest secondary to reversible complete atrioventricular block 40 days postprocedure. Complete left bundle‐branch block occurred in 14 patients, and 12 cases were transient. In the icVSD group, no complete atrioventricular block or death occurred, and one patient developed transient complete left bundle‐branch block. Conclusions In selected patients, transcatheter device closure of pmVSD and icVSD can be performed safely and successfully, with excellent medium‐ and long‐term results in children. |
| first_indexed | 2024-12-14T05:46:08Z |
| format | Article |
| id | doaj.art-d86c684abcb0494da1ee37449ad91005 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-14T05:46:08Z |
| publishDate | 2021-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-d86c684abcb0494da1ee37449ad910052022-12-21T23:14:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-06-01101110.1161/JAHA.120.020417Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term ResultsDiandong Jiang0Bo Han1Lijian Zhao2Yingchun Yi3Jianjun Zhang4Youfei Fan5Jianli Lv6Jing Wang7Yan Wang8Department of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaDepartment of Pediatric Cardiology Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan ChinaBackground In children, the practice of transcatheter closure of intracristal ventricular septal defect (icVSD) has been limited. Currently, there is a lack of comparison between device closure of perimembranous ventricular septal defect (pmVSD) and icVSD, and long‐term clinical outcomes are rare. Methods and Results This study included a total of 633 children (39 with icVSD and 594 with pmVSD), aged 18 months to 16 years, who underwent transcatheter closure of ventricular septal defect between January 2014 and December 2018. All patients were followed up until September 2020, with a median follow‐up of 46 months in the pmVSD group and 52 months in the icVSD group. The procedural success rate was 96.3% and 84.6% in pmVSD and icVSD groups, respectively (P=0.002). The median of age, weight, procedure time, fluoroscopic time, and radiation dose were greater in the icVSD group compared with the pmVSD group. More eccentric ventricular septal defect occluders were used in the icVSD group. Most adverse events were minor without any intervention, with cardiac rhythm/conduction abnormalities being the most common. In the pmVSD group, 2 patients experienced complete atrioventricular block, with one implanting a permanent pacemaker and the other dying of cardiac arrest secondary to reversible complete atrioventricular block 40 days postprocedure. Complete left bundle‐branch block occurred in 14 patients, and 12 cases were transient. In the icVSD group, no complete atrioventricular block or death occurred, and one patient developed transient complete left bundle‐branch block. Conclusions In selected patients, transcatheter device closure of pmVSD and icVSD can be performed safely and successfully, with excellent medium‐ and long‐term results in children.https://www.ahajournals.org/doi/10.1161/JAHA.120.020417intracristalperimembranoustranscatheter closureventricular septal defect |
| spellingShingle | Diandong Jiang Bo Han Lijian Zhao Yingchun Yi Jianjun Zhang Youfei Fan Jianli Lv Jing Wang Yan Wang Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease intracristal perimembranous transcatheter closure ventricular septal defect |
| title | Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results |
| title_full | Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results |
| title_fullStr | Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results |
| title_full_unstemmed | Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results |
| title_short | Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium‐ and Long‐Term Results |
| title_sort | transcatheter device closure of perimembranous and intracristal ventricular septal defects in children medium and long term results |
| topic | intracristal perimembranous transcatheter closure ventricular septal defect |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020417 |
| work_keys_str_mv | AT diandongjiang transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT bohan transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT lijianzhao transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT yingchunyi transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT jianjunzhang transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT youfeifan transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT jianlilv transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT jingwang transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults AT yanwang transcatheterdeviceclosureofperimembranousandintracristalventricularseptaldefectsinchildrenmediumandlongtermresults |