Abstract
Background Intracristal ventricular septal defect (icVSD) pose unique challenges in interventional cardiology. This study evaluated the use of eccentric occluders in icVSD treatment compared with that of standard symmetrical occluders for perimembranous ventricular septal defect (pmVSD), aiming to inform clinical practice.Objective To evaluate the clinical outcomes of the use of eccentric occluders for treating icVSD compared to the use of standard symmetrical occluders for treating pmVSD, with a focus on the success rate, cardiac function, complications, and quality of life.Materials and methods We conducted a comparative analysis of 39 patients with icVSD treated with eccentric occluders and 416 patients with pmVSD treated with symmetrical occluders. A comprehensive assessment of cardiac function recovery, complication occurrence, and changes in quality of life was performed during the intermediate and short-term follow-up periods.Results Of the 39 patients with icVSD, 38 successfully underwent occluder implantation, achieving a surgical success rate of 97.4%. Among the 416 patients with pmVSD, 413 achieved successful occluder implantation, yielding a surgical success rate of 99.3%. No statistically significant difference was observed in the success rates between the two groups. During the follow-up, both patient cohorts demonstrated notable improvements in cardiac function, the absence of severe complications, and improvements in quality of life. These findings underscore the feasibility and superiority of eccentric occluders in transcatheter closure of icVSD.Conclusions Our study demonstrated the high safety and efficacy of percutaneous transcatheter closure using eccentric occluders for treating icVSD. This investigation not only enhances our understanding of transcatheter closure options for icVSD patients but also provides clinicians with robust scientific evidence to guide treatment strategies. Ultimately, this approach may offer patients with icVSD a broadened range of therapeutic options and improved clinical outcomes.