Huang Liu Liu, Chen Mai, Zeng De Cai, Jiang Chun Lan, Ling Guo Xing, Su Chun Xiao, Zheng Bao Shi, Wu Ji
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Catheter Cardiovasc Interv. 2025 Sep;106(3):2018-2025. doi: 10.1002/ccd.70022. Epub 2025 Jul 24.
To reduce complications associated with metal occluders, bioabsorbable occluders have been implanted for perimembranous ventricular septal defects (VSDs) via transthoracic approach. This study investigates the feasibility of echocardiography-guided percutaneous closure of perimembranous VSDs in children using bioabsorbable occluders, along with its 1-year follow-up outcomes.
To evaluate the feasibility and 1-year outcomes of echocardiography-guided percutaneous closure of perimembranous VSDs using bioabsorbable occluders in children.
Between April 2023 and March 2024, consecutive children with perimembranous VSDs underwent percutaneous closure using bioabsorbable occluders under echocardiography guidance alone were enrolled. Procedural success was defined as percutaneous device implantation under sole ultrasound guidance with residual shunt ≤ 2 mm and no severe in-hospital complications. Preoperative, intraoperative, and follow-up data were prospectively collected and analyzed.
The study cohort comprised 14 children, including three with a subaortic rim ≤ 3 mm and one with a distance of ≤ 1 mm between the VSD and the tricuspid septal leaflet. All procedures were successful. Vascular access was via the femoral artery in six patients (42.9%) and femoral vein in eight patients (57.1%). No major complications occurred. A 2 mm residual shunt was noted in one patient (7.1%) and remained unchanged during the follow-up period. While new-onset mild/moderate tricuspid regurgitation occurred in three patients (21.4%), all cases showed improvement over time. At 1 year, no new onset aortic regurgitation or complete heart block were reported, and the occluders were largely absorbed.
Percutaneous closure of perimembranous VSDs in children using bioabsorbable occluders under echocardiography guidance is feasible, with promising 1-year outcomes.
为减少与金属封堵器相关的并发症，已通过经胸途径为膜周部室间隔缺损（VSD）植入生物可吸收封堵器。本研究探讨了超声心动图引导下使用生物可吸收封堵器经皮闭合儿童膜周部VSD的可行性及其1年随访结果。
评估超声心动图引导下使用生物可吸收封堵器经皮闭合儿童膜周部VSD的可行性及1年结局。
在2023年4月至2024年3月期间，连续纳入仅在超声心动图引导下使用生物可吸收封堵器经皮闭合膜周部VSD的儿童。手术成功定义为仅在超声引导下经皮植入装置，残余分流≤2 mm且无严重的院内并发症。前瞻性收集并分析术前、术中和随访数据。
研究队列包括14名儿童，其中3名主动脉下边缘≤3 mm，1名VSD与三尖瓣隔叶之间的距离≤1 mm。所有手术均成功。6例患者（42.9%）通过股动脉进行血管穿刺，8例患者（57.1%）通过股静脉进行血管穿刺。未发生重大并发症。1例患者（7.1%）出现2 mm的残余分流，随访期间保持不变。3例患者（21.4%）出现新发轻度/中度三尖瓣反流，但所有病例均随时间改善。1年时，未报告新发主动脉反流或完全性心脏传导阻滞，封堵器大部分已吸收。
超声心动图引导下使用生物可吸收封堵器经皮闭合儿童膜周部VSD是可行的，1年结局良好。
