Original article
Should perimembranous ventricular septal defects still be treated percutaneously?

Aim: Assessment of perimembraneous ventricular septal defects (VSD) treatment with the use of AMembrVSDO and evaluation of the early and late complication risk. Methods: In the period from June, 2003 to August, 2005, 17 patients were qualified for VSD transcatheter closure. Patients aged 1.2-18.0 years (mean 9.2±6.5), weighted 9.4-72.0 kg (mean 32.9±21.8). The follow-up period was 3-4 years.
Results: The procedure was performed successfully in 15 out of 17 children. The left ventricle end-diastolic dimension decreased statistically after the procedure (p=0.00005). One child (6.7%) suffered from a complete atrioventricular block after the VSD closure. Minor complications were observed in 4 (26.7%) cases. Statistically significant differences were observed between the size of the device and the short diameter of the VSD (p=0.7600), the long diameter of the VSD (p=0.8152), the angiographic diameter of the VSD (p=0.9210) as well as the proposed device (p=0.9202). After VSD closure, the number of patients with TI >I° decreased from 66.7% to 6.7% (p=0.0159) and, in case of those with MI, from 93.3% to 60% (p=0.0270).
Conclusion: Percutaneous closure of the perimembranous VSD with AMembrVSDO is a promising method of treatment. Nevertheless, more frequent occurrence of the complete heart block following the above-mentioned procedure in comparison to surgery indicates that the qualification for AMembrVSDO implantation should be performed very carefully. More data is needed to verify safety of this procedure.