Intraoperative device closure of subaortic ventricular septal defects.

Objectives: To evaluate the safety and the indication for percardiac device closure of subaortic ventricular septal defects (VSDs) under guidance of transesophageal echocardiography.

Methods: A total of 62 patients with VSDs immediately below the aortic valve underwent percardiac device closure without cardiopulmonary bypass.

Results: There were no deaths. Of 62 patients, 52 (83.9%) underwent successful closure and 10 (16.1%) were converted to open-heart surgery due to tricuspid regurgitation, aortic regurgitation, and a residual shunt. Multiple logistic regression analysis showed the type and diameter of VSD were associated with the failure of device closure. There were no severe adverse events. Follow-up ranged from 13 to 31 months (mean, 22.3 ± 5.2 months). Early and late complications occurred in 10 patients (19.2%) and two patients (3.8%), respectively.

Conclusions: Excellent short-term results can be achieved in selected patients with percardiac device closure of subaortic ventricular septal defects.