Scholarlink

Background <p>Transcatheter closure has become a widely accepted alternative to surgery for VSD, but long-term pediatric data are limited. This study evaluated procedural success, complications, and long-term outcomes with different occluders.</p> Methods <p>We retrospectively analyzed 118 children who underwent attempted transcatheter VSD closure between 2014 and 2024, with clinical, echocardiographic, and electrocardiographic follow-up.</p> Results <p>Closure was successful in 110 patients (93%). Failures were due to multifenestrated anatomy, embolization, residual shunt, atrioventricular (AV) block, tricuspid regurgitation, or insufficient aortic rim. Major complications occurred in six patients, including device embolization, progressive aortic regurgitation requiring surgery, persistent nodal rhythm requiring device removal, ventricular perforation, infective endocarditis, and subarachnoid hemorrhage. Minor complications included mild to moderate tricuspid regurgitation (n = 4) and mild aortic regurgitation (n = 5). Arrhythmic events comprised supraventricular tachycardia (n = 2, both resolved), nodal rhythm (n = 1, transient), right bundle branch block (n = 5, persistent in four), and left bundle branch block (n = 1, resolved). Residual shunt was present in 36.4% immediately, declining to 9.8% at follow-up. Larger VSD diameter (OR 1.75, 95% CI 1.14–2.69) and higher body weight (OR 1.07, 95% CI 1.00–1.15) were independent predictors. No late complete AV block, endocarditis, or embolization occurred. Patients treated with Konar-MF were younger and lighter, while Nit-Occlud was associated with higher residual shunt rates (85.7% vs. 33.0%, p = 0.010).</p> Conclusion <p>Transcatheter VSD closure in children demonstrated high success, acceptable complication rates, and favorable long-term outcomes. Results were influenced by device choice, defect size, and patient characteristics, highlighting the need for individualized strategies and continued surveillance.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Transcatheter ventricular septal defect closure in children: ten-year experience with multiple devices and long-term outcomes

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月1日

查看全文
  • Gamze Vuran,
  • Murat Muhtar Yılmazer,
  • Mertkan Bilen,
  • Cem Doğan,
  • Yusuf İlker Dur,
  • Ozan Hira,
  • Aykut Özön,
  • Ömer Faruk Gülaştı,
  • Mustafa Karaçelik,
  • Timur Meşe

摘要

Background

Transcatheter closure has become a widely accepted alternative to surgery for VSD, but long-term pediatric data are limited. This study evaluated procedural success, complications, and long-term outcomes with different occluders.

Methods

We retrospectively analyzed 118 children who underwent attempted transcatheter VSD closure between 2014 and 2024, with clinical, echocardiographic, and electrocardiographic follow-up.

Results

Closure was successful in 110 patients (93%). Failures were due to multifenestrated anatomy, embolization, residual shunt, atrioventricular (AV) block, tricuspid regurgitation, or insufficient aortic rim. Major complications occurred in six patients, including device embolization, progressive aortic regurgitation requiring surgery, persistent nodal rhythm requiring device removal, ventricular perforation, infective endocarditis, and subarachnoid hemorrhage. Minor complications included mild to moderate tricuspid regurgitation (n = 4) and mild aortic regurgitation (n = 5). Arrhythmic events comprised supraventricular tachycardia (n = 2, both resolved), nodal rhythm (n = 1, transient), right bundle branch block (n = 5, persistent in four), and left bundle branch block (n = 1, resolved). Residual shunt was present in 36.4% immediately, declining to 9.8% at follow-up. Larger VSD diameter (OR 1.75, 95% CI 1.14–2.69) and higher body weight (OR 1.07, 95% CI 1.00–1.15) were independent predictors. No late complete AV block, endocarditis, or embolization occurred. Patients treated with Konar-MF were younger and lighter, while Nit-Occlud was associated with higher residual shunt rates (85.7% vs. 33.0%, p = 0.010).

Conclusion

Transcatheter VSD closure in children demonstrated high success, acceptable complication rates, and favorable long-term outcomes. Results were influenced by device choice, defect size, and patient characteristics, highlighting the need for individualized strategies and continued surveillance.