Mid-term follow-up of perventricular device closure of subarterial ventricular septal defect_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XU Tiewei , XIE Lin ,  DIAN Ke

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

DIAN Ke, Email: pangzai356249@126.com

Keywords：

Subarterial ventricular septal defect; ventricular septal defect closure; efficacy; mid-term follow-up

DOI：

10.7507/1007-4848.202101069

Video：

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Objective To evaluate the mid-term safety, efficacy and feasibility of perventricular device closure for subarterial ventricular septal defect.Methods Clinical data of 97 patients diagnosed with subarterial ventricular septal defect through echocardiography in West China Hospital from September 2013 to December 2015 were retrospectively analyzed. There were 66 males and 31 females aged 3 (1.8, 5.9) years. All the patients underwent perventricular device closure under the guidance of transesophageal echocardiography using eccentric occlusion device. Possible complications such as residual shunt, valvular regurgitation, atrioventricular conduction block and arrhythmias were recorded during the 1-year, 3-year and 5-year follow-up.Results All the patients received perventricular device closure successfully except that 1 patient underwent open surgical repair under cardiopulmonary bypass 3 months later because of the migration of device. So the rate of complete closure was 99.0%. No residual shunt, moderate or severe valvular regurgitation, atrioventricular conduction block or arrhythmias were observed 5 years later.Conclusion Treating subarterial ventricular septal defect through perventricular device closure exhibits remarkable mid-term efficacy, safety and feasibility with high success rate.

Citation： XU Tiewei, XIE Lin, DIAN Ke. Mid-term follow-up of perventricular device closure of subarterial ventricular septal defect. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(11): 1334-1339. doi: 10.7507/1007-4848.202101069 Copy

1.	Kleinman CS, Tabibian M, Starc TJ, et al. Spontaneous regression of left ventricular dilation in children with restrictive ventricular septal defects. J Pediatr, 2007, 150(6): 583-586.
2.	Anderson RH, Wilcox BR. The surgical anatomy of ventricular septal defect. J Card Surg, 1992, 7(1): 17-35.
3.	Sim EK, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg, 1999, 67(3): 736-738.
4.	Chiu SN, Wang JK, Lin MT, et al. Aortic valve prolapse associated with outlet-type ventricular septal defect. Ann Thorac Surg, 2005, 79(4): 1366-1371.
5.	Cheung YF, Chiu CS, Yung TC, et al. Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect. Ann Thorac Surg, 2002, 73(2): 622-627.
6.	Mavroudis C, Baker CL, Idriss FS. Ventricular septal defect. In: Mavroudis C, Baker CL. Pediatric Cardiac Surgery. 3rd ed. Philadelphia: Mosby, 2003. 298-320.
7.	Demirag MK, Ke?eligil HT, Kolbakir F. Primary surgical repair of ventricular septal defect. Asian Cardiovasc Thorac Ann, 2003, 11(3): 213-216.
8.	蘇肇伉. 先天性心臟病微創手術的發展趨勢. 中國胸心血管外科臨床雜志, 2005, 12(4): 229-231.
9.	Lun K, Li H, Leung MP, et al. Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation. Am J Cardiol, 2001, 87(11): 1266-1270.
10.	Tweddell JS, Pelech AN, Frommelt PC. Ventricular septal defect and aortic valve regurgitation: Pathophysiology and indications for surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006, 9: 147-52.
11.	Szkutnik M, Qureshi SA, Kusa J, et al. Use of the Amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3): 355-358.
12.	Lock JE, Block PC, McKay RG, et al. Transcatheter closure of ventricular septal defects. Circulation, 1988, 78(2): 361-368.
13.	Chen ZY, Cao H, Ma YJ, et al. Transfemoral and perventricular device occlusions and surgical repair for doubly committed subarterial ventricular septal defects. Ann Thorac Surg, 2015, 99(5): 1664-1670.
14.	尹森林, 李曉, 朱達, 等. 經胸穿刺封堵術治療干下型室間隔缺損的安全性及有效性研究. 中國胸心血管外科臨床雜志, 2014, 21(5): 628-631.
15.	楊云龍, 徐路平. 國產新型鈦鎳合金室間隔缺損封堵器的組織相容性研究. 中華實用兒科臨床雜志, 2009, 24(11): 842-843.
16.	張勝康, 尹曉清, 徐朝軍, 等. 室間隔缺損封堵術后殘余分流的隨訪觀察. 世界最新醫學信息文摘, 2016, 16(75): 14-15.
17.	普金海, 安永, 欒果, 等. 239例小兒室間隔缺損修補術后殘余分流的近中期隨訪. 重慶醫科大學學報, 2020, 45(4): 477-481.
18.	高波濤, 鄭景浩, 陳會文, 等. 嬰幼兒室間隔缺損修補術后殘余分流的自發愈合. 中國胸心血管外科臨床雜志, 2011, 18(6): 507-509.
19.	Kenny D, Tometzki A, Martin R. Significant aortic regurgitation associated with transcatheter closure of perimembranous ventricular septal defects with a deficient aortic rim. Catheter Cardiovasc Interv, 2007, 70(3): 445-449.
20.	Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: Mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
21.	Zhu D, Lin K, Tang ML, et al. Midterm results of hybrid perventricular closure of doubly committed subarterial ventricular septal defects in pediatric patients. J Card Surg, 2014, 29(4): 546-553.
22.	Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation, 2014, 129(23): 2440-2492.
23.	Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: Results of the European Registry. Eur Heart J, 2007, 28(19): 2361-2368.
24.	Sullivan ID. Transcatheter closure of perimembranous ventricular septal defect: Is the risk of heart block too high a price? Heart, 2007, 93(3): 284-286.
25.	Latham RA, Anderson RH. Anatomical variations in atrioventricular conduction system with reference to ventricular septal defects. Br Heart J, 1972, 34(2): 185-190.

1. Kleinman CS, Tabibian M, Starc TJ, et al. Spontaneous regression of left ventricular dilation in children with restrictive ventricular septal defects. J Pediatr, 2007, 150(6): 583-586.
2. Anderson RH, Wilcox BR. The surgical anatomy of ventricular septal defect. J Card Surg, 1992, 7(1): 17-35.
3. Sim EK, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect. Ann Thorac Surg, 1999, 67(3): 736-738.
4. Chiu SN, Wang JK, Lin MT, et al. Aortic valve prolapse associated with outlet-type ventricular septal defect. Ann Thorac Surg, 2005, 79(4): 1366-1371.
5. Cheung YF, Chiu CS, Yung TC, et al. Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect. Ann Thorac Surg, 2002, 73(2): 622-627.
6. Mavroudis C, Baker CL, Idriss FS. Ventricular septal defect. In: Mavroudis C, Baker CL. Pediatric Cardiac Surgery. 3rd ed. Philadelphia: Mosby, 2003. 298-320.
7. Demirag MK, Ke?eligil HT, Kolbakir F. Primary surgical repair of ventricular septal defect. Asian Cardiovasc Thorac Ann, 2003, 11(3): 213-216.
8. 蘇肇伉. 先天性心臟病微創手術的發展趨勢. 中國胸心血管外科臨床雜志, 2005, 12(4): 229-231.
9. Lun K, Li H, Leung MP, et al. Analysis of indications for surgical closure of subarterial ventricular septal defect without associated aortic cusp prolapse and aortic regurgitation. Am J Cardiol, 2001, 87(11): 1266-1270.
10. Tweddell JS, Pelech AN, Frommelt PC. Ventricular septal defect and aortic valve regurgitation: Pathophysiology and indications for surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006, 9: 147-52.
11. Szkutnik M, Qureshi SA, Kusa J, et al. Use of the Amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects. Heart, 2007, 93(3): 355-358.
12. Lock JE, Block PC, McKay RG, et al. Transcatheter closure of ventricular septal defects. Circulation, 1988, 78(2): 361-368.
13. Chen ZY, Cao H, Ma YJ, et al. Transfemoral and perventricular device occlusions and surgical repair for doubly committed subarterial ventricular septal defects. Ann Thorac Surg, 2015, 99(5): 1664-1670.
14. 尹森林, 李曉, 朱達, 等. 經胸穿刺封堵術治療干下型室間隔缺損的安全性及有效性研究. 中國胸心血管外科臨床雜志, 2014, 21(5): 628-631.
15. 楊云龍, 徐路平. 國產新型鈦鎳合金室間隔缺損封堵器的組織相容性研究. 中華實用兒科臨床雜志, 2009, 24(11): 842-843.
16. 張勝康, 尹曉清, 徐朝軍, 等. 室間隔缺損封堵術后殘余分流的隨訪觀察. 世界最新醫學信息文摘, 2016, 16(75): 14-15.
17. 普金海, 安永, 欒果, 等. 239例小兒室間隔缺損修補術后殘余分流的近中期隨訪. 重慶醫科大學學報, 2020, 45(4): 477-481.
18. 高波濤, 鄭景浩, 陳會文, 等. 嬰幼兒室間隔缺損修補術后殘余分流的自發愈合. 中國胸心血管外科臨床雜志, 2011, 18(6): 507-509.
19. Kenny D, Tometzki A, Martin R. Significant aortic regurgitation associated with transcatheter closure of perimembranous ventricular septal defects with a deficient aortic rim. Catheter Cardiovasc Interv, 2007, 70(3): 445-449.
20. Lin K, Zhu D, Tao K, et al. Hybrid perventricular device closure of doubly committed subarterial ventricular septal defects: Mid-term results. Catheter Cardiovasc Interv, 2013, 82(3): E225-E232.
21. Zhu D, Lin K, Tang ML, et al. Midterm results of hybrid perventricular closure of doubly committed subarterial ventricular septal defects in pediatric patients. J Card Surg, 2014, 29(4): 546-553.
22. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation, 2014, 129(23): 2440-2492.
23. Carminati M, Butera G, Chessa M, et al. Transcatheter closure of congenital ventricular septal defects: Results of the European Registry. Eur Heart J, 2007, 28(19): 2361-2368.
24. Sullivan ID. Transcatheter closure of perimembranous ventricular septal defect: Is the risk of heart block too high a price? Heart, 2007, 93(3): 284-286.
25. Latham RA, Anderson RH. Anatomical variations in atrioventricular conduction system with reference to ventricular septal defects. Br Heart J, 1972, 34(2): 185-190.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Mid-term follow-up of perventricular device closure of subarterial ventricular septal defect

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