Transcatheter closure of doubly committed subarterial ventricular septal defect: Early to one-year outcome

Abstract

Background: The report of transcatheter doubly committed subarterial ventricular septal defect closure is limited. The objective was to evaluate the efficacy and outcome of transcatheter closure of doubly committed subarterial ventricular septal defect. Methods: Clinical records, procedural and early to one-year follow-up data of doubly committed subarterial ventricular septal defect patient who underwent transcatheter closure between 2013 and 2018 in Hasan Sadikin Hospital Bandung Indonesia were retrosprectively reviewed. Results: There were 40 patients of doubly committed subarterial ventricular septal defect who underwent transcatheter closure, consisted of 18 female and 22 male. The median of age was 8.8 (range 2.7–48) years, weight 24 (range 10.3–70) kg, and defect size 3.1 (1.24–7.4) mm. Mean pulmonary arterial pressure 23.4 SD 5.4 mmHg and flow ratio 1.65 SD 0.28. Median of latest follow-up was 14 months. No serious complications or death. The median length-of-stay period was 3 days, without intensive care admission. Failure to attempt in 3 cases, resulted 92.5% of acute procedural success rate. The acute efficacy was 37.5%, and increased up to 92% on latest follow-up. Of 7 patients with pre-existing aortic regurgitation, three was improved, two persisted, and one progressed to moderate regurgitation. New onset mild aortic regurgitation occurred in 1 patient, which persisted in the same degree during follow-up. Conclusion: Transcatheter closure of doubly committed subarterial ventricular septal defect is feasible, safe and effective as an alternative treatment to surgical closure in selected patient. The competence of the aortic valve remain the main concern and required further follow-up.

Keywords

• Transcatheter closure
• Ventricular septal defect
• Doubly committed subarterial
• Subpulmonary
• Infundibular
• Intracristal