Single arterial access closure of post-infarction ventricular septal defect: A case series

Catheter Cardiovasc Interv. 2023 Jan;101(1):209-216. doi: 10.1002/ccd.30510. Epub 2022 Dec 7.


Background: Post-infarction ventricular septal defect (PIVSD) carries a very poor prognosis. Surgical repair offers reasonable outcomes in patients who survive the initial healing period. Percutaneous device implantation remains a potentially effective earlier alternative.

Methods and results: From March 2018 to May 2022, 11 trans-arterial PIVSD closures were attempted in 9 patients from two centers (aged 67.2 ± 11.1 years; 77.8% male). Two patients had a second procedure. Myocardial infarction was anterior in four patients (44.5%) and inferior in five cases (55.5%). Devices were successfully implanted in all patients. There were no major immediate procedural complications. Immediate shunt grade postprocedure was significant (11.1%), minimal (77.8%), or none (11.1%). Median length of stay after the procedure was 14.8 days. Five patients (55%) survived to discharge and were followed up for a median of 605 days, during which time no additional patients died.

Conclusion: Single arterial access for percutaneous closure of PIVSD is a good option for these extremely high-risk patients, in the era of effective large-bore arterial access closure. Mortality remains high, but patients who survive to discharge do well in the longer term.

Keywords: amplatzer occluder device; percutaneous closure; trans-arterial access; ventricular septal defect.

MeSH terms

  • Anterior Wall Myocardial Infarction* / complications
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / methods
  • Cardiac Surgical Procedures* / adverse effects
  • Female
  • Heart Septal Defects, Ventricular* / surgery
  • Humans
  • Male
  • Myocardial Infarction* / complications
  • Myocardial Infarction* / diagnostic imaging
  • Myocardial Infarction* / therapy
  • Septal Occluder Device* / adverse effects
  • Treatment Outcome