Ventricular Septal Defect(VSD)is the most common congenital heart disease in children.A minority require closure to avoid complications. Surgical approach is the gold standard.Even if results of surgical closure of VSD are satisfactory, it is associated with complications and inherent risks of sternotomy. Today, Percutaneous Closure(PC)of VSD has become a valuable tool in place of surgery in some cases.
This was a retrospective, mono-centric and descriptive study of patients with a VSD in whom a PCVSD was performed. Patients were collected from our Cardiology department over a period from2014 to 2018.
Twelve PCVSD were performed. The median age of discovery of VSD was 4 months (2 months to 33 years).The average age of PC was 8 years(2 to 33 years), with a female predominance(8 girls).VSD were perimembranous in 6 cases, and trabecular in the others. The VSD was unique in all cases. The diameter of the VSD was on average 5.7mm(4 to 13mm). Left cavities were dilated in 9 patients. Pulmonary artery was dilated in 3 cases. The VSD was restrictive in 11cases.The prosthesis size was(on average 5/5mm),the largest was 6/6mm. The type of prosthesis used was ADO II in 11cases,and ADO I in 1case.The 12 VSD were successfully closed. A transient AVB occurred immediately after the closure of a trabecular VSD.A minimal residual shunt was present immediately after closure in 9 cases. After a month all patients were asymptomatic, a residual shunt persisted in 7 cases. SPAP remained stable in all cases and were reduced for the child who initially had PAH. Left cavities remained dilated in the 9patients.1 year after PC, all patients were asymptomatic. A residual shunt was noted in 4 cases. Only 5 patients retained moderate dilation of the left cavities.2patients were put on ACE inhibitor. The follow-up was 2.5 years.
PCVSD is a promising alternative to surgery. The results of our study are encouraging despite the small sample size and the absence of a surgical control group
Le texte complet de cet article est disponible en PDF.
Publié par Elsevier Masson SAS.