Risk Factors For Device Closure Of Doubly Committed Sub-Arterial Ventricular Septal Defects In Children

Objectives:To examine the critical factors that determine the success of percardiac device closure in doubly committed subarterial ventricular septal defects in children, by exploring the significance of Aortic Valve Prolapse, defect diameter and the body surface area of the patient in relation to percardiac device closure of doubly committed subarterial ventricular septal defects.Methods:There were30male patients and15female patients representing a66.7%and33.3%respectively. The mean age was3.44±2.36years and a mean body surface area of0.63±0.19m2that were diagnosed with doubly committed subarterial ventricular septal defects during the period of January2011to December2012who underwent percardiac device closure procedure. The procedure was carried out under guidance of continuous Transesophageal echocardiography. Their clinical data was retrospectively examined;Results:Device closure was successful in38patients giving an84.4%success rate.7patients were converted to open heart surgery. A total of17patients presented aortic valve prolapse before the procedure in which device closure failed in6of these patients. The mean defect size was4.1±1.8mm. The mean size of the devices used was6.3±1.5mm. There was no perioperation mortality or major post operation complications. All patients were reevaluated by Transesophageal echocardiography after implantation of the device and by Transthoracic echocardiography on the subsequent follow-ups. The follow up period ranged from10to30months.Conclusions:Percardiac device closure of doubly committed subarterial ventricular septal defects is suitable in select patients without moderate to severe coexisting aortic valve abnormality that contraindicates it, with a defect size less than5mm.