Safety and efficacy of using amplatzer ductal occluder type I and II for peri membranous ventricular septal defect closure: A systematic review

Abstract

BACKGROUND: Ventricular septal defect (VSD) is a common congenital heart defect that affects many individuals. Transcatheter closure has become a successful treatment method. However, certain devices used for closure can lead to life-threatening complications such as complete heart block. This systematic review aimed to assess the efficacy and safety of Amplatzer duct occluders (ADOs) types I and II for closing perimembranous VSDs (pmVSDs). METHODS: This review followed the PRISMA 2020 guidelines and searched multiple databases for English articles on pmVSD closure using ADO I/II published up to 2022. Relevant keywords were used and the data were categorized to report the incidence of common complications. RESULTS: The study, which involved 1,691 patients with primary pmVSD and ages ranging from 6 months to 15 years, found that ADO type I had a high success rate with low rates of complete heart block and other complications. ADO type II had a higher rate of severe complications, particularly complete heart block. The overall estimated success rate for device implantation was 97.3, with only one procedure-related death. The occurrence of complete heart block was 2.3, and residual shunts were the most frequent complication (4.8). CONCLUSION: The findings of this systematic review provide valuable insights into the use of ADO types I and II for closing pmVSDs. Healthcare professionals should be aware of these findings and closely monitor patients who undergo ADO device closure for pmVSDs. Further research is recommended to determine the specific indications for using each type of Amplatzer device in the relevant population.