The Comparison of Perventricular Device Closure with Transcatheter Device Closure and the Surgical Repair via Median Sternotomy for Perimembranous Ventricular Septal Defect

Ann Thorac Cardiovasc Surg. 2018 Dec 20;24(6):308-314. doi: 10.5761/atcs.oa.18-00085. Epub 2018 Jul 27.

Abstract

Background: Perventricular and transcatheter device closures are performed for perimembranous ventricular septal defect (pmVSD) to reduce the surgical trauma of conventional surgical repair via median sternotomy. Few comparative studies have been conducted among these three procedures.

Methods: From June 2015 to May 2016, 247 patients with isolated pmVSD who had undergone perventricular or transcatheter device closure or conventional surgical repair were reviewed to compare these three procedures.

Results: The procedure success rate was similar in these three groups. There were a statistically significant difference in operative time, aortic cross-clamping time, duration of cardiopulmonary bypass (CPB), blood transfusion amount, and medical cost in these three groups. Meanwhile, postoperative mechanical ventilation time, duration of intensive care, and length of hospital stay were longer in surgical group than the other two groups. The surgical group required the longest incision. No significant difference was noted in major adverse events. There were different advantages and disadvantages in these three kinds of procedures.

Conclusions: Device closure may be alternative to conventional surgical repair for patients with isolated pmVSD. Perventricular device closure was the preferred procedure because it showed more maneuverable than transcatheter procedure with the same clinical result.

Keywords: congenital heart diseases; perventricular devices occlusions; surgery; transcatheter; ventricular septal defect.

Publication types

  • Comparative Study

MeSH terms

  • Blood Transfusion
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / instrumentation*
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / instrumentation*
  • Cardiopulmonary Bypass
  • Child, Preschool
  • Female
  • Heart Septal Defects, Ventricular / diagnostic imaging
  • Heart Septal Defects, Ventricular / surgery
  • Heart Septal Defects, Ventricular / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Male
  • Operative Time
  • Postoperative Complications / therapy
  • Prosthesis Design
  • Respiration, Artificial
  • Risk Factors
  • Septal Occluder Device*
  • Sternotomy* / adverse effects
  • Time Factors
  • Treatment Outcome