Open Access

ARTICLE

Effectiveness and Safety of Transcatheter Closure of Various Ventricular Septal Defects Using Second-Generation Amplatzer Duct Occluders

Jianming Wang, Qiguang Wang^*, Xiaotang Sheng, Jingsong Geng, Jiawang Xiao, Xianyang Zhu^*

Department of Congenital Heart Disease, General Hospital of Northern Theater Command, Shenyang, China

* Corresponding Authors: Xianyang Zhu. Email: ; Qiguang Wang. Email:

Congenital Heart Disease 2023, 18(2), 183-195. https://doi.org/10.32604/chd.2022.021855

Received 09 March 2022; Accepted 14 July 2022; Issue published 15 March 2023

Abstract

Objective: This study was designed to determine the long-term safety and efficacy of using the Amplatzer Duct Occluder II (ADO II) for the closure of various ventricular septal defects (VSDs). Methods: From January 2011 to December 2019, selected VSD patients were treated through transcatheter intervention using ADO II occluders. The closure results and complications from 188 patients, involving 167 perimembranous ventricular septal defects (pmVSDs), 9 intracristal VSDs, 11 post surgery residual shunts and 1 post closure residual shunt with the mean outlet diameter3.1 ± 0.8 mm under angiography, were enrolled in this study. Results: The success rate was 98.9% for all procedures. During the median 77-month follow-up period, no cases of complete atrioventricular block (cAVB), infective endocarditis or death occurred. One major adverse event (0.5%) was recorded: cerebrovascular accident occurred 1 day after the procedure in one patient who was transferred to the neurology department. The residual shunt rate was 44.6%, which was the most common minor adverse event. The cardiac conduction block rate was 4.3%. Specifically, one pmVSD patient developed intermittent LBBB during the 28-month follow-up. There were 3 patients (1.6%) with new-onset mild tricuspid insufficiency, and the insufficiency degree was stable during follow-up. There was no new-onset aortic insufficiency that occurred. Conclusions: Transcatheter closure of pmVSDs, some intracristal VSDs, some postsurgery or postclosure residual shunts using ADO II occluders were both safe and effective and yielded excellent long-term results in selected patients.

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