Early Institutional Experience of Transcatheter Device Closure of Perimembranous Ventricular Septal Defect in Adults at Lampang Hospital: A Case Series
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Abstract
Background: Transcatheter closure of perimembranous ventricular septal defect (pmVSD) is a less invasive alternative to surgical repair in selected patients. However, data from regional hospitals in Thailand remain limited.
Objective: To report the clinical outcomes, complications, and feasibility of transcatheter pmVSD closure using
the Cocoon® VSD Occluder in selected adult patients at Lampang Hospital.
Materials and methods: A retrospective case series including all consecutive patients (n = 4) who underwent transcatheter pmVSD closure at the Cardiology Unit, Lampang Hospital, between May 2022 and July 2024. The Cocoon® VSD Occluder (Vascular Innovations Co., Ltd., Thailand) was used in all cases. Clinical, echocardiographic, and electrocardiographic outcomes were assessed at baseline and at 1, 6, and 12 months post-procedure.
Results: All four patients (mean age 31.8 ± 7.0 years; 50% female) achieved procedural success. Complete device closure was confirmed immediately after deployment by transesophageal echocardiography in all cases. No major complications were observed, including no complete atrioventricular block (CAVB), no device embolization, no new aortic regurgitation, and no hemolysis. Mean right ventricular systolic pressure (RVSP) showed a decreasing trend from 43.1 ± 22.4 mmHg at baseline to 28.9 ± 6.2 mmHg at 12 months. Mean left ventricular internal diameter at diastole (LVIDd) decreased from 47.8 ± 5.3 mm at baseline to 44.5 ± 3.3 mm at 12 months; however, individual changes were not uniform across all patients. All patients remained in New York Heart Association (NYHA)
functional class I throughout follow-up, with resolution of exertional dyspnea in the one symptomatic patient. Post-procedural hospital stay was 1 day in all patients.
Conclusion: Transcatheter closure of pmVSD using the Cocoon® VSD Occluder appeared feasible with no major
complications observed in this small early experience at a regional tertiary hospital. Longer follow-up and studies in larger cohorts are needed to confirm these findings.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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