Abstract:

Objective To analyze the common complications of the transcatheter and the surgical approach to correct perimembranous ventricular septal defect (pmVSD) in children, and to provide a basis for clinically individualized optimal treatment plan. Methods The clinical data of hospitalized children diagnosed with pmVSD between June 2014 and April 2020 were retrospectively analyzed. Based on the final surgical approach, 284 patients were divided into interventional and repair groups. Common postoperative complications and follow-up data between these two groups were analyzed. Results Of the 499 children finally enrolled. 284 cases were in the interventional group, 130 males and 154 females, with a median age of 42.0 (33.0-56.0) months, and 215 cases were in the repair group, 100 males and 115 females, with a median age of 40.0 (30.0-60.0) months. There was no statistically significant difference in the incidence of residual shunt, aortic valve, mitral valve, and tricuspid regurgitation within 1 week after surgery between the two groups (P>0.05). The incidence of new arrhythmias and complete and incomplete right bundle branch block within 1 week postoperatively was higher in the repair group than in the intervention group, and the difference was statistically significant (P<0.05). At the end of follow-up, residual shunt, valve regurgitation and conduction block were significantly improved in both groups, with no statistically significant differences between the two groups (P>0.05). Conclusion Interventional occlusion and surgical repair are equally effective in treating perimembranous ventricular septal defects in children, and interventional treatment is less invasive and has fewer complications.

Key words: ventricular septal defect, catheter closure, surgical closure, complication