Abstract
Background We report our experience of using perventricular device closure (PVDC) in treating
perimembranous ventricular septal defect (pm-VSD) with emphasis on technical and morphological
considerations.
Method Thirty-one pediatric patients with pm-VSD who underwent successful PVDC were enrolled
in this study. The pm-VSDs were divided into three different types (type I: tunnel
shape; type II: with subaortic rim < 2 mm; type III: membranous aneurysm formation).
Four closure strategies were utilized, corresponding to the morphology of the pm-VSD.
Results Mean age of the patients was 2.1 years with mean VSD diameter 5.8 mm. Seven patients
had type I VSD, nine presented with type II, and 15 had type III. Twenty-two concentric
and nine eccentric devices were used with mean device size 7.3 mm. Complete closure
was achieved in 97% of cases during follow-up. Procedure-induced tricuspid regurgitation
(TR) was noted in nine patients at discharge; four resolved. Multivariable analysis
showed that the procedure-induced TR was associated with the device size (odds ratio = 5.059;
95% confidence interval = 1.431–17.880).
Conclusion Different closure strategies allow for PVDC of various types of pm-VSDs in selected
pediatric patients.
Keywords
perventricular device closure - ventricular septal defect - pediatric patients
