Open Access

ARTICLE

Transcatheter Closure of Postoperative Residual Atrial or Ventricular Septal Shunts in Patients with Congenital Heart Disease

Jiawang Xiao, Jianming Wang, Zhongchao Wang, Lili Meng, Ming Zhao, Qiguang Wang^*
Department of Congenital Heart Disease, General Hospital of Northern Theater Command, Shenyang, 110016, China
* Corresponding Author: Qiguang Wang. Email:

Congenital Heart Disease https://doi.org/10.32604/chd.2024.051427

Received 05 March 2024; Accepted 23 April 2024; Published online 29 May 2024

Abstract

Background: Transcatheter closure (TCC) has emerged as the preferred treatment for selected congenital heart disease (CHD). While TCC offers benefits for patients with postoperative residual shunts, understanding its mid- and long-term efficacy and safety remains crucial. Objective: This study aims to assess the mid- and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction. Methods: In this consecutive retrospective study, we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022. TCC candidacy was determined based on established criteria. Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up. Results: Among the patients, 5 (14.3%) exhibited interatrial shunting, while 30 (85.7%) had interventricular shunting. TCC was successfully implemented in 33 of 35 patients, with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation. This resulted in a TCC success rate of 94.3%. Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case; all resolved by the three-month follow-up after TCC. Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period. During a median follow-up of 73 months, there were no instances of residual shunt, device embolization, occluder displacement, valve insufficiency, malignant arrhythmia, infective endocarditis, death, or other serious complications. Conclusion: TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction. These findings support the consideration of TCC as the preferred treatment option for appropriate patient populations.

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Keywords

Congenital heart disease; residual shunt; transcatheter closure; surgical repair

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