Transthoracic Device Closure of Juxtaarterial Ventricular Septal Defects: Midterm Follow-Up Results.

BACKGROUND

In recent years, minimally invasive transthoracic device closure has been introduced as an alternative treatment option for selected patients with juxtaarterial ventricular septal defects. This study evaluated the midterm safety and efficacy of using device closure in selected patients.

METHODS

Between January 2008 and December 2014, 25 patients with juxtaarterial ventricular septal defects who met the inclusion criteria were enrolled in this study. Periventricular closure was attempted using minimally invasive transthoracic device closure without cardiopulmonary bypass under general anesthesia and transesophageal echocardiography guidance. Patients were strictly monitored according to a standard protocol by one specially appointed doctor.

RESULTS

Minimally invasive transthoracic device closure was successfully performed in 23 patients (92%) with a median age of 18 months. Device closure failed in 2 patients (1 with aortic regurgitation and 1 with right ventricular outflow tract stenosis), and they were converted to an open operation. No severe complications (device shift, significant arrhythmia, ventricular outflow tract obstruction, or obvious valve regurgitation) were observed. There was no closure-associated valve regurgitation. No patient had worrisome progression of aortic regurgitation or pulmonary regurgitation.

CONCLUSIONS

In select patients, minimally invasive transthoracic device closure of juxtaarterial ventricular septal defects appears to be safe and effective, with good midterm outcomes.