Acute and midterm results following perventricular device closure of muscular ventricular septal defects: A multicenter PICES investigation

Robert G. Gray*, Shaji C. Menon, Joyce T. Johnson, Aimee K. Armstrong, Michael A. Bingler, John P. Breinholt, Damien Kenny, John Lozier, Joshua J. Murphy, Shyam K. Sathanandam, Nathaniel W. Taggart, Sara M. Trucco, Bryan H. Goldstein, Brent M. Gordon

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalCatheterization and Cardiovascular Interventions
Volume90
Issue number2
DOIs
StatePublished - Aug 1 2017

Keywords

  • VSD device closure
  • hybrid
  • midterm outcomes
  • muscular ventricular septal defects
  • perventricular

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Gray, R. G., Menon, S. C., Johnson, J. T., Armstrong, A. K., Bingler, M. A., Breinholt, J. P., Kenny, D., Lozier, J., Murphy, J. J., Sathanandam, S. K., Taggart, N. W., Trucco, S. M., Goldstein, B. H., & Gordon, B. M. (2017). Acute and midterm results following perventricular device closure of muscular ventricular septal defects: A multicenter PICES investigation. Catheterization and Cardiovascular Interventions, 90(2), 281-289. https://doi.org/10.1002/ccd.27121