Long-Term Performance after Interventional VSD Closure—Single Center Experience in Pediatric and Adult Patients

Objectives: The ventricular septal defect is the most common congenital heart defect and transcatheter device treatment has become increasingly acceptable because of its advantages to the surgical approach. But still long-term data are missing. This study analyses the outcome of interventional VSD closure with the focus on short and long-term complications: residual shunt and AV-block.

Methods: Single-center study with the use of 196 catheterization procedures performed at the German Heart Centre in Berlin between 1993 and 2018 were retrospectively reviewed. Furthermore, we examined long-term results of a follow-up group whose last follow-up date was >1 year after the interventional VSD closure.

Result: One hundred and ninety-six patients with interventional closure of VSD were included and 140 perimembranous, 34 muscular, 19 residual/ postsurgical, and 3 multiple VSD’s were closed in this cohort. 116x Amplatzer Membranous or Muscular VSD Occluder, 24x Nit-Occlud Lê VSD, 19x Amplatzer Duct Occluder II, 19x Amplatzer Duct Occluder I, 8x Lifetech Konar MFO, and 10x others devices were implanted. The median age was 6.2 (0.01–66.1) years, median height 117 (49–188) cm, and median weight 20.9 (3.2–117) kg. Only one complete atrioventricular block occurred after 4 days (leading to device removal) and 4 of 196 devices were surgically removed (due to dislocation). Median follow-up time of the long-term follow-up group was 6.3 (1.1–21.3) years and closure-rate was 85.7%, which differed for the used devices. In the long-term follow-up, there were only 3 of 196 cases of tachyarrhythmia needing a treatment but no atrioventricular block occurred.

Conclusion: Interventional closure of VSDs is feasible and safe in selected patients with a minimal risk of severe side effects and offers benefits to surgical closure. Long-term data confirms a really low rate for complete AV-block by using different devices. Still additional studies are mandatory to compare the effectiveness and safety of this procedure and devices.