Background: Residual VSD may occur after surgery. Redo operation have higher rate of morbidity and mortality.
Patients and methods Between January 00 and November 08, 162 pts underwent percutaneous VSD closure. Nineteen pts had a residual postsurgical VSD. They were operated on a median of 8 years before the percutaneous procedure. All pts had echocardiographic signs of left ventricle volume overload. The Amplatzer muscular VSD occluder (mVSD) and the eccentric VSD occluder (pmVSD) were used.
Results Median age at procedure was 18 years (range 1,5–64 yrs).Median weight was 55 kgs (range 9–80 kgs).Median QP/QS was 1,8/1 (range 1,5-2.5).Mean fluoroscopy and procedure times were 41+/-31 and 135+/-91 min, respectively. The median size of the VSD was 8 mm (range 6-18 mm). In 12 pts a mVSD device was used, while in 7 cases a pmVSD device was implanted. In one subject two procedures and devices were needed. No death occurred. Two pts required immediate external cardioversion due to ventricular tachycardia.
A mild to trivial intraprotesic residual shunt was showed in three pts. All subjects but one were discharged home 48 hours after the procedure. Median follow-up was 18 months (range 2-48 mts).Complete occlusion was shown in all subjects. No late complications occurred. One subject experienced recurrent VSD due to patch dehiscence and finally she was sent to surgical repair.
Conclusion In the current era, percutaneous closure of residual post surgical VSD can be achieved safely and successfully.