A Mid-Long-Term Follow-Up On Patients After Transcathter Closure Of Ventricular Septal Defect By Transthoracic Echocardiographic

Objective A mid-long-term follow-up study on the changes of cardiac geometric morphology and cardiac function after transcatheter closure of ventricular septal defect (VSD)Methods Follow up data were analyzed in 377 VSD patients who underwent transcatheter closure in the First Affiliated Hospital of Guangxi Medical University from July 2003 to December 2011. Left atrium end-systolic diameter (LAESD), left ventricular end-diastolic diameter (LVEDD), right ventricular end-diastolic diameter (RVEDD), left ventricular ejection fraction (LVEF), main pulmonary artery diameter (MPAD) of adult VSD patients and regurgitation of each valve of all VSD patients were measured before and after transcatheter closure for 3d, 1m,3m,6m, 1y,3y,5y,7-10y using transthoracic echocardiographic (TTE). LVEDD/RVEDD of adult VSD patients was calculated.Results 1. In adult VSD patients:LAESD, LVEDD, MPAD, LVEDD/RVEDD were reduced after operation for 3d, 1m,3m,6m, 1y,3y and 5y when compared with pre-operation, respectively(all P<0.05). Also, LVEDD and LVEDD/RVEDD were reduced after operation for lm,3m,6m, 1y,3y and 5y compared with 3d after operation, respectively (all P<0.05). There was no difference in RVEDD between before and after operation (P>0.05). LVEF was slightly decreased compared with pre-operation, but the results were not statistically significant (all P> 0.05).2. In all VSD patients:Incidence of aortic regurgitation (AR) was increased after operation compared with pre-operation (all P<0.05). Incidence of tricuspid regurgitation (TR) was increased after operation for 3d, lm,3m,6m compared with pre-operation (all P<0.05), but reduced after operation for lm, 3m,6m, 1y compared with 3d after operation (all P<0.05), and there was no difference between before and after operation for 1y,3y,5y,7-10y (P>0.05).3. During the follow-up period, severe tricuspid regurgitation was found in one case, slightly residual shunt were found in two case, right ventricular outflow tract septum(RVOTS) were found in five case.Conclusions 1. In adult patients, cardiac geometric morphology could be effectively recovered in a month after operation.2. It need pay great attention to that the incidence of AR and TR was increased after operation compared with pre-operation.3. Interventional therapy is a safe and effective method for ventricular septal defects.4. TTE is the preferred examination method to follow up after operation, which plays an important guiding role in clinical for evaluating the prognosis of VSD. Also TEE could be used to observe the changes of cardiac geometric morphology and cardiac function after transcatheter closure termly and repeatedly.