Double occluders by transcatheter interventional techniques to close complex membranous ventricular septal defect with aneurysm

AIM:To investigate the feasibility, effectiveness and reliability of double occluders by transcatheter interventional techniques in closing complex membranous ventricular septal defect (VSD) with aneurysm. METHODS: Twelve patients suffering from complex membranous VSD with aneurysm underwent transcatheter interventional therapy with double VSD occluders. After left ventriculography, the pathway was established from the right femoral artery to the right femoral vein through the left ventricle, VSD, right ventricle, right atrium and inferior vena cava. The polysheath was inserted from the right femoral vein introduced by the pathway to the left ventricle, and the first occluder was implanted through the polysheath. Left ventriculography was again performed. In case of any unacceptable residual shunt, the pathway was established from the right femoral artery to the left femoral vein and the second occluder was implanted to close the residual shunt using the same procedure. Echocardiography and contrast examination were performed to confirm results. All patients were followed-up with echocardiography, electrocardiogram and X-ray examination at 1, 3, 6 and 12 months after the catheter procedure. RESULTS: Procedures were successful in all 12 patients. Echocardiography and contrast examination performed immediately after operation showed that the effect was satisfactory with no residual shunt, valvular regurgitation, or other complications. During follow-up, cardiac murmur disappeared in all patients, and no residual shunt or aortic regurgitation was found. All patients had persistent sinus rhythm with no atrioventricular block or bundle branch block. CONCLUSION: Application of double occluders to close complex membranous VSD by interventional procedure is feasible, effective and safe.