Echocardiography-guided transcatheter closure of perimembranous ventricular septal defects with aortic valve prolapse

CHEN Mai; HUANG Liu-liu; JIANG Chun-lan; ZENG De-cai; ZHENG Bao-shi

doi:10.3969/j.issn.1672-5301.2025.02.001

Abstract：Objective To investigate the clinical effect of transcatheter closure of congenital perimembranous ventricular septal defect(pmVSD)with aortic valve prolapse under the guidance of echocardiography and the risk factors of adverse events.Methods From April 2018 to January 2024,42 patients with pmVSD with aortic valve prolapse underwent echocardiography-guided transcatheter closure in the Department of Cardiac Surgery,the First Affiliated Hospital of Guangxi Medical University were included.The general data of patients were collected.The changes of aortic valve and tricuspid valve regurgitation were observed during follow-up.The major adverse survival events and major adverse cardiac events were recorded.The Kaplan-Meier method was used to draw the survival curve and the log-rank test was used to compare the follow-up results.Univariate Cox regression analysis was used to analyze the risk factors of major adverse cardiac events.Results The success rate of occlusionwas 95.2％(40/42).The survival follow-up time was(36.6±21.4)months,and no major adverse survival events occurred.The aortic regurgitation and tricuspid regurgitation were reduced after the operation.The survival free from major adverse cardiac events were not different significantly among the different AVP groups.Univariate Cox regression analysis showed that the size of ventricular septal defect and depth of the aortic valve prolapse were the risk factors for postoperative residual shunt and incomplete bundle branch block.Conclusion If the preoperative evaluation and interventional methods are appropriate,transcatheter closure of pmVSD with aortic valve prolapse under the guidance of echocardiography has little effect on the aortic valve,and the short and mid-term clinical results are satisfactory.