Transcatheter Closure of Perimembranous Ventricular Septal Defects Using Dual Wire-Maintaining Technique

Objective The present study was designed to evaluate the safety and feasibility of transcatheter closure of perimembranous ventricular septal defects (PmVSDs) with dual wire-maintaining technique (DWMT). Patients/ Methods From January 2010 to December 2013, a total of 241 patients (men: 109, women: 132; mean age: 22.2 +/- 15.4 years) with congenital PmVSDs were randomised to either the conventional technique (CT) group (n=118) or the DWMT group (n=123). Results In the CT group, the track wire was withdrawn before occluder insertion. In the DWMT group, the track wire was maintained in the delivery sheath during the procedure. Both the procedure time and fluoroscope time were reduced significantly in the DWMT group patients who required device replacement compared with CT group patients (median time: 46.0 +/- 14.8 min vs. 56.0 +/- 15.2 min, p<0.05; 15.0 +/- 11.6 min vs. 22.0 +/- 10.1 min, p<0.05). There was no difference in the incidence of complications between the two groups. Conclusion The DWMT is safe and feasible for transcatheter treatment of PmVSDs, especially in patients requiring device replacement, for it avoids reconstruction of the "arteriovenous wire loop'', left ventriculography from the contralateral femoral route, or the use of a larger femoral artery short sheath.