Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors
Objectives: To evaluate the causes and risk factors of unplanned surgery after transcatheter closure of ventricular septal defect (VSD) in children.Methods: A total of 773 patients with VSD who had the devices transcatheter released between January 2013 and December 2018 in our institution were retr...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:decfc614911242f5b03d6f9c803dc8972021-12-01T19:46:44ZUnplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors2296-236010.3389/fped.2021.772138https://doaj.org/article/decfc614911242f5b03d6f9c803dc8972021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.772138/fullhttps://doaj.org/toc/2296-2360Objectives: To evaluate the causes and risk factors of unplanned surgery after transcatheter closure of ventricular septal defect (VSD) in children.Methods: A total of 773 patients with VSD who had the devices transcatheter released between January 2013 and December 2018 in our institution were retrospectively reviewed. Univariate and multivariate analyses were used to identify the risk factors for unplanned surgery.Results: Twenty four patients (3.1%) underwent unplanned surgery after transcatheter closure of VSD. The most common cause for unplanned surgery was new-onset or worsening aortic regurgitation (14/24; 58.3%), followed by occluder migration (4/24; 16.7%), complete atrioventricular block (2/24; 8.3%), severe hemolysis (2/24; 8.3%), residual shunt (1/24; 4.2%), and occluder edge near the tricuspid valve chordae (1/24; 4.2%). Logistic regression analysis revealed that primary aortic valve prolapse (OR: 5.507, 95%CI: 1.673–18.123, P = 0.005); intracristal VSD (OR: 8.731, 95%CI: 2.274–33.527, P = 0.002); eccentric occluder (OR: 4.191, 95%CI: 1.233–14.246, P = 0.022); larger occluder size (OR: 1.645, 95%CI: 1.331–2.033, P < 0.001); and pulmonary artery systolic pressure ≥45 mmHg (OR: 4.003, 95%CI: 1.073–14.941, P = 0.039) were risk factors for unplanned surgery.Conclusions: New-onset or worsening aortic regurgitation was the primary cause for unplanned surgery after transcatheter closure of VSD in children. Primary aortic valve prolapse, intracristal VSD, eccentric occluder, larger occluder size, pulmonary artery systolic pressure ≥45 mmHg could increase the risk of unplanned surgery.Penghui YangPenghui YangPenghui YangPenghui YangZhijun WuZhiyuan LiuZhiyuan LiuZhiyuan LiuZhiyuan LiuJing ZhangJing ZhangJing ZhangJing ZhangHao ZhouXiaojuan JiXiaojuan JiXiaojuan JiXiaojuan JiQijian YiQijian YiQijian YiQijian YiMi LiMi LiMi LiMi LiFrontiers Media S.A.articleventricular septal defecttranscatheter closureunplanned surgerycauses and risk factorschildrenPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021) |
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| topic |
ventricular septal defect transcatheter closure unplanned surgery causes and risk factors children Pediatrics RJ1-570 |
| spellingShingle |
ventricular septal defect transcatheter closure unplanned surgery causes and risk factors children Pediatrics RJ1-570 Penghui Yang Penghui Yang Penghui Yang Penghui Yang Zhijun Wu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Jing Zhang Jing Zhang Jing Zhang Jing Zhang Hao Zhou Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Qijian Yi Qijian Yi Qijian Yi Qijian Yi Mi Li Mi Li Mi Li Mi Li Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| description |
Objectives: To evaluate the causes and risk factors of unplanned surgery after transcatheter closure of ventricular septal defect (VSD) in children.Methods: A total of 773 patients with VSD who had the devices transcatheter released between January 2013 and December 2018 in our institution were retrospectively reviewed. Univariate and multivariate analyses were used to identify the risk factors for unplanned surgery.Results: Twenty four patients (3.1%) underwent unplanned surgery after transcatheter closure of VSD. The most common cause for unplanned surgery was new-onset or worsening aortic regurgitation (14/24; 58.3%), followed by occluder migration (4/24; 16.7%), complete atrioventricular block (2/24; 8.3%), severe hemolysis (2/24; 8.3%), residual shunt (1/24; 4.2%), and occluder edge near the tricuspid valve chordae (1/24; 4.2%). Logistic regression analysis revealed that primary aortic valve prolapse (OR: 5.507, 95%CI: 1.673–18.123, P = 0.005); intracristal VSD (OR: 8.731, 95%CI: 2.274–33.527, P = 0.002); eccentric occluder (OR: 4.191, 95%CI: 1.233–14.246, P = 0.022); larger occluder size (OR: 1.645, 95%CI: 1.331–2.033, P < 0.001); and pulmonary artery systolic pressure ≥45 mmHg (OR: 4.003, 95%CI: 1.073–14.941, P = 0.039) were risk factors for unplanned surgery.Conclusions: New-onset or worsening aortic regurgitation was the primary cause for unplanned surgery after transcatheter closure of VSD in children. Primary aortic valve prolapse, intracristal VSD, eccentric occluder, larger occluder size, pulmonary artery systolic pressure ≥45 mmHg could increase the risk of unplanned surgery. |
| format |
article |
| author |
Penghui Yang Penghui Yang Penghui Yang Penghui Yang Zhijun Wu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Jing Zhang Jing Zhang Jing Zhang Jing Zhang Hao Zhou Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Qijian Yi Qijian Yi Qijian Yi Qijian Yi Mi Li Mi Li Mi Li Mi Li |
| author_facet |
Penghui Yang Penghui Yang Penghui Yang Penghui Yang Zhijun Wu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Zhiyuan Liu Jing Zhang Jing Zhang Jing Zhang Jing Zhang Hao Zhou Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Xiaojuan Ji Qijian Yi Qijian Yi Qijian Yi Qijian Yi Mi Li Mi Li Mi Li Mi Li |
| author_sort |
Penghui Yang |
| title |
Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| title_short |
Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| title_full |
Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| title_fullStr |
Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| title_full_unstemmed |
Unplanned Surgery After Transcatheter Closure of Ventricular Septal Defect in Children: Causes and Risk Factors |
| title_sort |
unplanned surgery after transcatheter closure of ventricular septal defect in children: causes and risk factors |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/decfc614911242f5b03d6f9c803dc897 |
| work_keys_str_mv |
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