Objectives: We sought the safety, efficacy, and follow-up results of transcatheter closure of VSD using different types of devices and coils.
Methods: 47 patients underwent to transcatheter closure of VSD during the last two years. In perimembranous VSDs, left side of the device was inserted either to left ventricular side of the septum or into the aneurysm to avoid AV block.
Results: The median age was 6 (0,42-50) years. The median Qp/Qs ratio was 1.74 (1.2-4.0), and the median VSD diameter was 9 mm (3.5-20 mm). Implantation was successful in 44 (93.6%) patients with 31 perimembranous, 13 muscular VSDs. 15 Amplatzer muscular and 6 membranous VSD occluders, 9 Nitt-occlud coil (PFM), 7 Cardiofix muscular VSD occluders, 6 Amplatzer duct occluders and one detachable coil (Cook) were used. Complete occlusion rate was 50% at completion of the procedure, rising to 66% the day after and 72,7% at sixth month during the follow-up. No major complication was encountered except transient complete AV block and hemolysis in one patient. Patients that the device implanted into the aneurysm have high residual shunts the day after the procedure, comparing to patients that the left disc of the device inserted to the left ventricular side (7/11 vs 3/20, respectively, p=0,006).
Conclusions: Transcatheter closure of VSD with different types of devices is an effective and safe procedure. Device insertion into aneurysm is an alternative in perimembranous VSD thought to have decreased possibility of AV block but tend to have increased residual shunt in early period.