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Acute and midterm results following perventricular device closure of muscular ventricular septal defects: A multicenter PICES investigation
Author(s) -
Gray Robert G.,
Me Shaji C.,
Johnson Joyce T.,
Armstrong Aimee K.,
Bingler Michael A.,
Breinholt John P.,
Kenny Damien,
Lozier John,
Murphy Joshua J.,
Sathanandam Shyam K.,
Taggart Nathaniel W.,
Trucco Sara M.,
Goldstein Bryan H.,
Gordon Brent M.
Publication year - 2017
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27121
Subject(s) - medicine , concomitant , cardiopulmonary bypass , ventriculotomy , cardiology , atrioventricular block , adverse effect , percutaneous , closure (psychology) , retrospective cohort study , surgery , single center , market economy , ventricle , economics
Objectives To describe acute and mid‐term results of hybrid perventricular device closure of muscular ventricular septal defects (mVSDs). Background Perventricular device closure of mVSDs can mitigate technical limitations of percutaneous closure and need for cardiopulmonary bypass or ventriculotomy with a surgical approach. Methods This is a multicenter retrospective cohort study of patients undergoing hybrid perventricular mVSD device closure from 1/2004 to 1/2014. Procedural details, adverse events, outcomes, and follow‐up data were collected. Patients were divided into two groups: (1) simple (mVSD closure alone) and (2) complex (mVSD closure with concomitant cardiac surgery). Results Forty‐seven patients (60% female) underwent perventricular mVSD device closure at a median age of 5.2 months (IQR 1.8–8.9) and weight of 5.1 kg (IQR 4.0–6.9). Procedural success was 91% [100% ( n = 22) simple and 84% ( n = 21/25) complex]. Adverse events occurred in 19% (9/47) [9% (2/22) simple and 28% (7/25) complex]. Hospital length of stay (LOS) was shorter in the simple vs. complex group (4 vs. 14 days, P < 0.01). At mid‐term follow‐up of 19.2 months (IQR 2.3–43) 90% of pts had complete mVSD closure; none developed late heart block, increased atrioventricular (AV) valve insufficiency or ventricular dysfunction. Conclusions Perventricular device closure of simple mVSD was associated with a high rate of procedural success, few adverse events, and short hospital LOS. Procedural adverse events were associated with the presence of concomitant complex surgery. Residual mVSD, AV valve insufficiency, or ventricular dysfunction were uncommon at mid‐term follow‐up. © 2017 Wiley Periodicals, Inc.