Cardiac Remodeling and Tricuspid Valve Outcomes After Transcatheter Perimembranous VSD Closure in Pediatric Patients

Abstract

Background: Paediatric patients frequently experience tricuspid regurgitation as a result of a perimembranous ventricular septal defect (pmVSD), which may get better when the defect is closed. The aim of this research was to evaluate how transcatheter pmVSD closure affected children's cardiac remodelling & TR severity.

Methods: among September2023 & March2025, 55 paediatric studied cases receiving treatment at Minya University Hospital & the National Heart Institute with haemodynamically significant pmVSD & at least mildTR participated in a prospective observational study. Under the direction of fluoroscopic and echocardiographic imaging, patients underwent transcatheter closure. Transthoracic echocardiograms were used to measure the ejection fraction, left ventricular end diastolic/systolic dimensions, & TR severity at baseline, one, & six months. statistical analysis (SPSS v26) was employed.

Results: Following the surgery, there were notable decreases in the severity of TR: at 6 months, the tricuspid regurgitation jet area fell from 4.63cm² to 1.16cm², mildTR declined from 2.98cm² to 0.72cm², moderateTR decreased from 6.6cm² to 1.2cm², & severeTR reduced from 10.4cm² to 4.2cm² (all p<0.001). After 6months, there had been a significant improvement in left ventricular dimensions, with LVESD going from 26.8mm to 23.8mm & LVEDD going from 43.18mm to 39.4mm (both p<0.001). From 65.3percent to 67.1percent, LVEF rose (p<0.001). There were no reports of residual shunts. There were only 2 studied cases (3.6%) who had minor issues.

Conclusion: With good clinical & functional results, transcatheter closure seems to be a safe & efficient treatment for PmVSD linked to TR.