A systematic review on the efficacy and safety of transcatheter device closure of ventricular septal defects (VSD)

J Interv Cardiol. 2014 Jun;27(3):260-72. doi: 10.1111/joic.12121. Epub 2014 Apr 29.


Background: Advances in interventional techniques now allow for transcatheter treatment of some ventricular septal defects (VSD), although there remain concerns about adverse events. We performed a systematic review to look at outcomes and complications associated with transcatheter closure of VSD.

Method: A PubMed search for series in English on device closure of VSD from 2003 to June 2012 was performed. We excluded small series that were included in multicenter studies and patients who had acquired VSD following myocardial infarction. The random effects model was used to obtain pooled estimates of success and complications.

Results: A total of 37 publications comprising 4,406 patients with VSD (perimembranous = 3,758, muscular = 419, intracristal = 47, doubly committed subarterial = 36, multiple = 16, postsurgical = 123, unclassified = 7) were included in this analysis. The age of patients ranged from 3 days to 84 years. The pooled estimate of successful device implantation was 96.6% (95% CI: 95.7-97.5). The most common complication is residual shunt (pooled estimated 25.5%; 95% CI: 18.9-32.1). Others included valvular defects (pooled estimate 4.9%; 95% CI: 3.4-6.4) and arrhythmias (pooled estimate 10.6%; 95% CI: 8.4-12.7).

Discussion and conclusion: Our analysis suggests that transcatheter device closure of VSD is safe and yields good results. The limitations of this study are difficulties in analyzing different devices individually, and segregating the different VSD types. Further stratification by type of VSD, age of patients, and prevention of complications is needed before this can be recommended for routine treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged, 80 and over
  • Arrhythmias, Cardiac* / epidemiology
  • Arrhythmias, Cardiac* / etiology
  • Cardiac Catheterization / methods
  • Female
  • Heart Septal Defects, Ventricular* / classification
  • Heart Septal Defects, Ventricular* / surgery
  • Heart Valve Diseases* / epidemiology
  • Heart Valve Diseases* / etiology
  • Humans
  • Infant, Newborn
  • Male
  • Postoperative Complications / epidemiology*
  • Prosthesis Implantation / adverse effects*
  • Prosthesis Implantation / instrumentation
  • Prosthesis Implantation / methods
  • Septal Occluder Device*
  • Treatment Outcome