# Feasibility, outcomes and follow-up analysis of transcatheter closure of outlet ventricular septal defect with various devices from North-Eastern India: a single centre observational study

## TL;DR

This study evaluates the effectiveness of transcatheter closure for outlet ventricular septal defects in North-Eastern India using three devices, showing promising short- to mid-term outcomes.

## Contribution

The study provides new evidence on the feasibility and outcomes of transcatheter closure for outlet VSDs using three different devices in a specific regional population.

## Key findings

- Transcatheter closure was successful in 76.2% of patients with outlet VSDs.
- Most residual shunts resolved within one year, and AR progression was minimal.
- No major complications like outflow obstruction or device embolization were observed.

## Abstract

Outlet septum ventricular septal defects (VSDs) are notably more prevalent in North-Eastern India and often associated with aortic valve prolapse, leading to a need for surgical intervention. While surgical methods remain the conventional approach, there is an opportunity to explore the effectiveness of transcatheter closure techniques.

This study aimed to assess the effectiveness and follow-up of transcatheter closure for outlet and outlet muscular type VSDs using three distinct devices: Amplatzer ADO II, KONAR MF VSD Occluder, and Cocoon VSD Occluder. This Descriptive study with follow-up observation up to 1 year was conducted at Health City Hospital in Guwahati, India, from March 2023 to November 2025, involving 21 patients who met the criteria for inclusion.

Among the 21 patients, transcatheter closure was successfully achieved in 16 individuals, resulting in a success rate of 76.2%. The mean diameter of the VSDs was 3.8 mm, with 66.6% of the cases showing pre-existing aortic valve prolapse. Closure attempts were unsuccessful in five patients, who subsequently received surgical intervention. In the successful cases, the Amplatzer ADO II was implanted in 7 patients (43.7%), the KONAR MFO in 8 patients (50%), and the Cocoon VSD occluder in 1 patient (6.3%). Seven patients exhibited mild intra-device residual shunts, and 37.5% (6/16) experienced a transient increase in aortic regurgitation (AR) after 24 hours post-procedure. Importantly, follow-up after one year showed static or non-progression of pre-existing AR, with worsening of AR (moderate severity) observed only in one patient, and the majority of residual shunts resolved. No major complications like outflow obstruction or device embolization were reported in the present study.

The results indicate that transcatheter closure of outlet and outlet muscular type VSDs is a promising option for selected patients, yielding positive short- to mid-term outcomes. Further long-term follow-up will enhance our understanding of the procedure’s safety and efficacy, paving the way for broader application of this technique in clinical practice.

The online version contains supplementary material available at 10.1186/s43044-026-00719-6.