Comparison of perventricular and percutaneous ultrasound-guided device closure of perimembranous ventricular septal defects

BackgroundUltrasound-guided percutaneous device closure of perimembranous ventricular septal defects (PmVSD) is a minimally invasive recent treatment approach. Perventricular PmVSD device closure is an emerging radiation-free intervention, yet it comes with certain limitations. No studies compared both of these treatment approaches.MethodsWe performed a retrospective institutional data comparison of percutaneous (PCP Group, n = 138) and perventricular (PVP Group, n = 67) ultrasound-guided device closure procedures in 205 patients with PmVSD between March 2017 and December 2022.ResultsPatients of the PCP and PVP groups had a median age of 4.9 years (IQR, 3.1–14.0) and 5.3 years (IQR, 3.4–13.1) respectively. The median PmVSD diameter in the PCP Group was 4.0 mm (IQR, 3.3–5.3) and 5.2 mm (IQR, 4.0–7.0) in the PVP Group (p = 0.001). There was no significant difference in success rates between the PCP and PVP Groups (intention-to-treat population, 88.4% vs. 92.5%, p = 0.36; as-treated population, 88.4% vs. 89.3%, p = 0.84). 5/8 failed percutaneous cases that were shifted to the perventricular approach were successful. Compared to the PVP Group, patients of the PCP group experienced a significant decrease in ventilation time, drainage volume, and postoperative hospital stay (p