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GW24-e2166 Clinical analysis of treatment for 1149 cases of membranous ventricular septal defect by interventional therapy in children
  1. Zhu Xianyang
  1. General Hospital of Shenyang Military Region, Department of Congenital Heart Disease

Abstract

Objectives To assess the characteristics and clinical experience of treatment for paediatric ventricular septal defect by interventional therapy.

Methods We collected 1149 children with VSD who received interventional therapy from 2001 June to 2012 February. There were 578 males and 571 females, age 2.5–16 (6.8 ± 3.1) years old and weight 8–54 (24.7 ± 10.6) kg. III-IV systolic regurgitant murmur could be heard at left sternal border between 3–4 intercostal space, pulmonic second sound enhanced or split. UCG showed the diameter of VSD was 2–8 (4.3 ± 1.1) mm. Left ventricular angiography showed the left ventricular surface is 4 ∼ 20 (6.38 ± 3.17) mm, right ventricular surface is 3 ∼ 10 (3.81 ± 1.75) mm and the distance from upper VSD margin to aortic valve is 0 ∼ 6 (2.67 ± 1.61) mm. 464 patients combined with membranous ventricular septal aneurysm, 15 patients combined with patent ductus arteriosus, 16 patients combined with atrial septal defect and 4 patients combined with muscular VSD.

Results The closure was successful conducted in 1125 patients and the success rate was 98.2%. The diameters of occluder were 4–16 (7.56 ± 2.12) mm. The patients who combined with PDA or ASD, VSD was firsted closed and then PDA or ASD. The patients combined with muscular VSD received occlusion simultaneously. 1061 patients (94.3%) had no shunt instantly, 38 patients (3.4%) had a small shunt and 26 patients (2.3%) had a trace of shunt. 1 cases of postoperative occluder shedding and the occluder was removed and patient received surgical repair of ventricular septal defect. 11 cases of postoperative III degree AVB, 1 patient underwent surgical operation and the rest recovered. 1 patient had III degree AVB 3 years after the occlusion and returned to normal after treatment. 75 cases of complete left bundle branch block, 3 patients did not recovered in the follow up and the rest became normal or not complete left bundle branch block. 1 cases of postoperative hematuria and the symptom disappeared after treatment.

Conclusions Strictly indications, standardised operation, proficient skill are the keys to reduce complications and improve the success rate in interventional therapy of VSD. Occlusion of paediatric membrane VSD is a safe, reliable, effective treatment. But its long-term efficacy still need long-term follow-up.

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