AIM To compare effects of a 2 mm waist-long occlude and analyze arrhythmia after transcatheter closure of perimembranous ventricular septal defect (pmVSD) with a 3~4 mm waist occluder.
METHODS From June 2008 to December 2014, 450 cases of pmVSD patients were diagnosed at First Affiliated Hospital, and preoperative echocardiography (TTE) showed indications of interventional occlusion. According to the morphology and size of the left ventricular septal defect, and in combination with the preoperative TTE examination, an individualized occluder was selected. The ECG was monitored and TTE was reviewed after the operation to observe the therapeutic effect, and the occurrence of arrhythmia was counted for comparative analysis.
RESULTS All 450 patients underwent occlusion after angiography, but 444 patients were successfully treated with a success rate of 99.2%. According to the difference in the use of occluders, all patients were divided into a short waist group (2 mm waist-long occluder used) and a long waist group (3~4)mm long occluder used. There were no significant differences in the success rate between the two groups (P > 0.05). The incidence of postoperative arrhythmia in the long waist group was significantly lower than that in the short waist group (P < 0.05). The incidence of supraventricular arrhythmia and right bundle branch block in the short waist group was significantly higher than that in the long waist group. There were 3 cases of III °AVB 1 of Ⅰ° AVB in the short waist group. But in the long waist group there was only 1of Ⅰ° AVB.
Conclusion The interventional therapy with the 3~4 mm waist pmVSD occluder appears to be safe and effective and can be used as the first choice for patients. The incidence of supraventricular arrhythmia and right bundle branch block after operation is lower.
DownLoad: