Indications for ventricular septal defect occlusion

  Indications for interventional closure of ventricular septal defect: (1) age >3 years, weight >10kg; (2) diameter of ventricular septal defect: the diameter of the left ventricular surface of the perimembranous defect is 3-12mm, the diameter of the large hole of the defect should be ≥2mm if the right ventricular side of the perimembranous defect is porous, and the diameter of the left ventricular surface of the defect should be 13-18mm if the perimembranous defect is complicated by a membrane tumor in children <10mm. (3) The distance of the periventricular defect edge from the aortic right coronary valve: eccentric blocker >1.5 mm, symmetric blocker >2.0 mm; meanwhile, the aortic right coronary valve prolapse leaflet does not obscure the defect orifice, does not combine with pathological aortic regurgitation, and the stump of the myocardial defect should be greater than 5 mm from the aortic valve. (4) distance between the defect edge and the right atrioventricular valve (tricuspid valve): eccentric blocker ≥2 mm, symmetric blocker >1.5 mm, without obvious right atrioventricular valve abnormalities and moderate right atrioventricular regurgitation, the distance between the stump of the myocardial defect and the right atrioventricular valve should be greater than 5 mm; (5) residual shunt after surgery; (6) mild to moderate pulmonary hypertension without right-to-left shunt (7) acute myocardial infarction combined with myocardial septal defect or trauma-induced myocardial septal defect; (8) combined cardiovascular malformations that can be treated interventionally without surgery; (9) left ventricular enlargement; contraindications to interventional occlusion of ventricular septal defect: (1) the defect is too large; (2) the local anatomy of the ventricular septal defect is not suitable for interventional treatment and affects aortic valve or atrioventricular valve function after placement (3) venous thrombosis at the catheter insertion site and thrombus at the blocker placement site; (4) severe pulmonary hypertension and right-to-left shunt with cyanosis (Eisenmenger’s syndrome); (5) aortic valve prolapse and aortic insufficiency; (6) aortic regurgitation of moderate degree or greater; (7) preoperative significant atrioventricular block or bundle branch block, and intraoperative third-degree atrioventricular block (8) Combination of other congenital heart malformations that cannot be intervened and require surgical treatment; (9) Active endocarditis, intracardiac redundancy, or other infections causing bacteremia; (10) Sub-stem ventricular septal defect.  Complications of interventional occlusion of ventricular septal defects: (1) arrhythmia; (2) displacement or dislodgement of the occluder; (3) residual shunt; (4) mechanical hemolysis; (5) aortic insufficiency; (6) tricuspid insufficiency; (7) headache, stroke, transient ischemia; (8) cardiac perforation, pericardial tamponade; (9) infective endocarditis; (10) occlusion of the anterior descending branch of the left coronary artery (10) apical ventricular wall aneurysm; (11) coronary artery air embolism, myocardial infarction