The Impact of Short or Long Transcatheter Occluder Waist Lengths on Postprocedure Complete Atrioventricular Block: A Retrospective Study.

Background: Complete atrioventricular block (cAVB) is considered the most serious adverse event after transcatheter closure of ventricular septal defect (VSD).

Objectives: To evaluate the incidence of postprocedure cAVB and its relationship with different waist lengths of transcatheter occluders.

Methods: This is a retrospective study of patients with VSD who had been treated with transcatheter closure at the Shanghai Changhai Hospital from December 2001 to December 2010. Patients were treated with short-waist (n = 234) or long-waist occluders (n = 571). All patients were monitored by electrocardiogram (ECG) within 7 days post procedure.

Results: Nine patients (3.8%) treated with short-waist occluders suffered from cAVB and 3 patients (1.3%) required permanent pacemaker implantation, compared with 4 patients (0.7%) and 1 patient (0.2%), respectively, in the long-waist occluder group (P<.001). There was a significantly higher incidence of postprocedure incomplete right bundle branch block (IRBBB) in patients treated with short-waist occluders compared with patients treated with long-waist occluders. There were no significant differences in other procedure-related complications between the two groups.

Conclusions: Long-waist VSD occluders are beneficial in the prevention of cAVB and the need for pacemaker implantation after transcatheter closure of VSD.