Recent achievements in transcatheter closure of ventricular septal defects: a systematic review of literature and a meta-analysis

BACKGROUND Ventricular septal defect (VSD) is one of the most common congenital heart defects. Currently, surgery remains the treatment of choice. However, transcatheter techniques for closing of various types of VSDs have become an alternative. AIMS The objective of our study was to present the outcomes of transcatheter closure of various types of VSD based on a systematic review of recent publications. METHODS A systematic review of studies published in English between January 2014 and March 2020 was performed using the PubMed database (MEDLINE) independently by 2 reviewers. Data on success and complication rates were extracted. Studies including fewer than 5 patients and those with acquired VSD were excluded from the analysis. RESULTS Finally, 44 studies were included for analysis, with a total number of 4050 patients. The pooled estimate of the overall success rate based on the random effects model was 97.96% (95% CI, 97.37-98.56; Q test P<0.001; I-2 = 50%). Early residual shunt was the most common complication with a pooled estimate rate of 22.25% (95% CI, 16.46-28.05; P <0.001;I-2 = 95%). However, only 92 patients had permanent VSD. Complete atrioventricular block constituted the most dangerous complication, and the pooled estimate rates were assessed as 0.64% (95% CI, 0.39-0.88;I-2 = 0%) for transient VSD and 0.32% (95% CI, 0.15-0.49; P >0.99;I-2 = 0%) for permanent VSD. CONCLUSIONS Transcatheter closure of selected VSDs a ppears to be an effective and safe method of treatment. Recent studies have shown high rates of successful interventions with a low incidence of complications.