Percutaneous punctured transcatheter device closure of ventricular septal defect

Objective To explore the feasibility of percutaneous puncture for ventricular septal defect(VSD). Methods From March 2015, we did percutaneous punctured transcatheter device closure of VSD for 22 patients. The patients included 15 males and 7 females with age from 2 years 6 months to 11 years 7 months, weight from 13.5 kg to 44.0 kg. Among 22 patients, 6 were diagnosed with residual shunt after VSD repair, with size of residual shunt from 4.8 mm to 7.0 mm. Residual shunts are perimembranous, conoventricular and intracristal. The other 16 patients were diagnosed with isolated VSD, with defect size from 3.5 to 5.1 mm. For all patients, we punctured directly through the right ventricular surface into the right ventricle in the 3th or 4th intercostal space of the left sternal border. Next, we succeeded to extract the guide wire after inserting a conveyor tube for 21 patients. Subsequently, 7-10 mm VSD closure device were delivered via the conveyor tube. Only one patient was changed to perform occlusion of VSD through chest small incision due to improper selection of punctured position. Results A total of 21 closure devices were placed for 21 patients. 18 of them are equilateral device, and 3 are decentered device, with size from 5 mm to 10 mm. There were small amount of pericardial effusion in 4 patients using TEE examination, and no future treat was performed after observation. For one-year follow-up, all patients have recovered very well. Conclusion Percutaneous punctured transcatheter device closure fits for treatment for children with residual shunt after VSD repair and isolated VSD. It has a good recent result. Key words: Ventricular septal defect; Percutaneous punctured; Transcatheter device closure; Residual shunt