Midterm Results of Hybrid Perventricular Closure of Doubly Committed Subarterial Ventricular Septal Defects in Pediatric Patients

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To evaluate the safety and efficiency of using hybrid perventricular closure in treating pediatric patients with the doubly committed subarterial ventricular septal defects (VSD).


Ninety pediatric patients with doubly committed subarterial VSD were enrolled from October 2007 to September 2010 in this retrospective study. Among them, 41 underwent open-heart surgery (surgical group), while 49 underwent perventricular device closure (perventricular group).


There was no difference in age (4.36 ± 3.21 vs. 5.82 ± 4.32 years, p > 0.05) between the two groups. VSD diameter was significantly larger in the surgical group than in the perventricular group (5.03 ± 1.31 vs. 6.03 ± 1.94 mm, p < 0.05). There were no major complications such as death, severe valve insufficiency, significant residual shunt, or lethal arrhythmias in two groups. The perventricular group was associated with a significant reduction of transfusion rate (18.4% vs. 97.6%, p < 0.05) as well as mean intensive care unit (ICU) stay (0.97 ± 0.53 vs. 2.78 ± 3.00 days, p < 0.05) in comparison with the surgical group. No difference was noted for complete closure rate between two groups at discharge (97.6% vs. 85.7%, p > 0.05) as well as during follow-up (97.6% vs. 95.9%, p > 0.05). Perventricular device closure was not associated with an increased risk of procedure-induced aortic insufficiency compared with the open-heart surgical group during follow-up (14.3% vs. 14.6%, p > 0.05).


Hybrid perventricular closure may be an alternative to open-heart surgery in selected pediatric patients with doubly committed subarterial VSD. doi: 10.1111/jocs.12361(J Card Surg 2014;29:546–553)

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