Evaluation of long-term outcomes following right ventricular vs. left ventricular approaches in transcatheter VSD closure

Abstract

Background: Ventricular septal defect (VSD) is one of the most common congenital heart abnormalities, characterized by abnormal communication between the left and right ventricles or, less frequently, between the left ventricle and right atrium. The study aims to evaluate the long-term outcomes of right ventricular versus left ventricular approaches in transcatheter VSD closure. Method: This trial at Ibn Al-Bitar Center (March 2023–May 2024) compared RV-to-LV and LV-to-RV approaches for transcatheter VSD closure in 97 patients. Outcomes were monitored post-procedure, with patients discharged the next day. Results: This study of 97 VSD patients compared RV-to-LV and LV-to-RV approaches. The RV-to-LV method had shorter fluoroscopy times for moderate and large VSDs and no aortic regurgitation, unlike the LV-to-RV approach (P = 0.01). Overall, RV-to-LV was safer and more efficient in selected cases. Conclusion: The RV-to-LV approach for transcatheter VSD closure is safer and more efficient, with shorter procedure times and fewer complications compared to LV-to-RV. The LV-to-RV method remains an option for complex cases but has a higher risk of complications like aortic regurgitation.