Hostname: page-component-54dcc4c588-m259h Total loading time: 0 Render date: 2025-10-10T12:55:11.063Z Has data issue: false hasContentIssue false

Transcatheter closure of ventricular septal defect with aortic cusp prolapse with or without mild aortic regurgitation: experience from tertiary care referral hospital from Eastern India

Published online by Cambridge University Press:  11 August 2025

Mahua Roy
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Sucheta Barman*
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Debasree Gangopadhyay
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Somrita Laha
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Shantanu Jain
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Priyantha Goyal
Affiliation:
Department of Pediatric Cardiology, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
Joyeeta Dutta
Affiliation:
Department of Pediatric Cardiac Intensive Care, NH-Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India
*
Corresponding author: Sucheta Barman; Email: sucheta2108@gmail.com

Abstract

Objective:

To evaluate feasibility, safety, and short-term outcome of transcatheter closure of ventricular septal defect with aortic cusp prolapse with or without mild aortic regurgitation.

Methods:

All data were collected prospectively for all ventricular septal defect with aortic cusp prolapse with or without mild aortic regurgitation who were attempted for transcatheter device closure between January 2018 and December 2023.

Results:

The device closure was successful and not associated with appearance of new-onset aortic regurgitation or aggravation of existing trivial to mild aortic regurgitation in 92.6% cases. In 2 patients (2.9%), device appeared to be touching the aortic valve and aggravating aortic regurgitation even after repositioning and re-deploying the device and ultimately that devices were taken out and sent for surgical closure. In 1 patient, device position appeared to be perfect on table before release, aortic regurgitation was same as before, and aortic root angiogram was also satisfactory. But re-evaluation on the next day by echocardiography revealed aggravating aortic regurgitation. The patient was sent for removal of device and surgical ventricular septal defect closure. In 2 patients (2.9%), device was embolised few hours after release, and the patients were sent for surgical closure. All patients were followed up for minimum of 6 months, and no case was found with new-onset aortic regurgitation or aggravation of existing aortic regurgitation.

Conclusion:

Transcatheter closure of ventricular septal defect with aortic cusp prolapse with or without mild aortic regurgitation in selected patients is technically feasible and safe with high procedural success rate.

Information

Type
Original Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Penny, DJ, Vick, GW3rd. Ventricular septal defect. Lancet 2011; 377: 11031112.CrossRefGoogle ScholarPubMed
Monsefi, N, Zierer, A, Risteski, P, et al. Long term results of aortic valve resuspension in patients with aortic valve insufficiency and aortic root aneurysm. Interact Cardiovasc Thorac Surg 2014; 18: 432437.CrossRefGoogle ScholarPubMed
Fu, YC. Transcatheter device closure of muscular ventricular septaldefect. Pediatr Neonatol 2011; 52: 34.CrossRefGoogle Scholar
Perloff, JK. The Clinical Recognition of Congenital Heart Disease. 6th ed. WB Saunders, Philadelphia, 2012, pp. 283331.Google Scholar
Tomita, H, Arakaki, Y, Ono, Y, Yamada, O, Yagihara, T, Echigo, S. Impact of noncoronary cusp prolapse in addition to right coronary cusp prolapse in patients with a perimembranous ventricular septal defect. Int J Cardiol 2005; 101: 279283.CrossRefGoogle ScholarPubMed
Pan, S, Xing, Q, Cao, Q, et al. Perventricular device closure of doubly committed subarterial ventral septal defect through left anterior mini thoracotomy on beating hearts. Ann Thorac Surg 2012; 94: 20702075.CrossRefGoogle Scholar
Ross-Hesselink, JW, Mejiboom, FJ, Spitaels, SEC, et al. Outcome of patients after surgical closure of ventricular septal defect at a young age: longitudinal follow-up of 22–34 years. Eur Heart J 2004; 25: 10571062.CrossRefGoogle Scholar
Mavroudis, C, Backer, CL, Jacobs, JP. Ventricular septal defect. In: Mavroudis, C, Backer, CL (eds). Pediatric Cardiac Surgery, 3rd ed. Mosby Inc, 2003, 298320.Google Scholar
Hobbins, SM, Izukawa, T, Radford, DJ, Williams, WG, Trusler, GA. Conduction disturbances after surgical correction of ventricular septal defect by the atrial approach. Br Heart J 1979; 41: 289293.CrossRefGoogle ScholarPubMed
Bol-Raap, G, Weerheim, J, Kappetein, AP, Witsenburg, M, Bogers, AJ. Follow-up after surgical closure of congenital ventricular septal defect. Eur J Cardiothorac Surg 2003; 24: 511515.CrossRefGoogle ScholarPubMed
Kitagawa, T, Durham, LA, Mosca, RS, Bove, EL. Techniques and results in the management of multiple ventricular septal defects. J Thorac Cardiovasc Surg 1998; 115: 848856.CrossRefGoogle ScholarPubMed
Wollenek, G, Wyse, R, Sullivan, I, Elliot, M, de Leval, M, Stark, J. Closure of muscular ventricular septal defects through a left ventriculotomy. Eur J Cardiothorac Surg 1996; 10: 595598.CrossRefGoogle ScholarPubMed
Serraf, A, Lacour-Gayet, F, Bruniaux, J, et al. Surgical management of isolated multiple ventricular septal defects: logical approach in 130 cases. J Thorac Cardiovasc Surg 1992; 103: 347–342.CrossRefGoogle ScholarPubMed
Backer, CL, Winters, RC, Zales, VR, et al. The restrictive muscular ventricular septal defect: howsmall is too small to close? Ann Thorac Surg 1993; 56: 10141019.CrossRefGoogle Scholar
Warnes, CA, Williams, RG, Bashore, TM, et al. ACC/AHA 2008 Guidelines for the management of adults with congenital heart disease: a report of the American college of cardiology/American heart association task force on practice guidelines. Circulation 2008; 52: e714e833.Google Scholar
Chen, GL, Li, HT, Li, HR, et al. Transcatheter closure of ventricular septal defect in patients with aortic valve prolapse and mild aortic regurgitation: feasibility and preliminary outcome. Asian Pac J Trop Med 2015; 8: 315318.CrossRefGoogle ScholarPubMed
Ghosh, S, Sridhar, A, Solomon, N, Sivaprakasham, M. Transcatheter closure of ventricular septal defect in aortic valve prolapse and aortic regurgitation. Indian Heart J 2018; 70: 528532.CrossRefGoogle ScholarPubMed
Lin, A, Mahle, WT, Frias, PA. Early and delayed atrioventricular conduction block after routine surgery for congenital heart disease. J Thorac Cardiovasc Surg 2010; 140: 158160. DOI: 10.1016/j.jtcvs.2009.12.050.CrossRefGoogle ScholarPubMed
Laurens, P, Gavelle, P, Piwnica, A, Farge, C, Dubost, C, Maurice, P. Severe postoperative heart blocks appearing late. 16 cases. Arch Mal Coeur Vaiss 1983; 76: 11321139.Google ScholarPubMed
Azab, S, Shahawy, HE, Samy, A, Mahdy, W. Permanent complete heart block following surgical closure of isolated ventricular septal defect. Egypt J Chest Dis Tuberc 2013; 62: 529533.CrossRefGoogle Scholar
Siehr, SL, Hanley, FL, Reddy, VM, Miyake, CY, Dubin, AM. Incidence and risk factors of complete atrioventricular block after operative ventricular septal defect repair. Congenit Heart Dis 2014; 9: 211215. DOI: 10.1111/chd.12110.CrossRefGoogle ScholarPubMed
Morris, CD, Reller, MD, Menashe, VD. Thirty-year incidence of infective endocarditis after surgery for congenital heart defect. JAMA 1998; 279: 599603.CrossRefGoogle ScholarPubMed