Catheter based closure of ventricular septal defects.

BACKGROUND: Catheter based treatment for heart diseases is increasing. Rikshospitalet has been the leading force in Norway to introduce such methods. We present the results of such treatment for different defects in the ventricular septum (VSD).

MATERIAL AND METHODS: Thirty seven patients catheterised with the purpose of closing a VSD with catheter-based techniques were reviewed. Two patients had VSD after myocardial infarction, ten had muscular and 25 had perimembranous VSD.

RESULTS: In two patients with perimembranous VSD the attempts were unsuccessful. One patient with muscular and one with post-infarction-VSD had to be catheterised twice. All perimembranous VSD, except one, were completely closed (96%). Complications included one patient who developed a complete heart block requiring a pacemaker, and another who got an intermittent left bundle branch block. Of the muscular VSD four (40%) closed completely, but the residual defects were small and clinically insignificant. None of them developed haemolysis. Both patients with post-infarction-VSD had small leaks, but improved clinically.

CONCLUSION: Catheter-based closure of VSD is a good alternative to open heart surgery. At present our own and the reported incidence of complete AV blocks lead us to be cautious when recommending closure of perimembranous VSD.