Case Report: Transcatheter closure of ventricular septal defect using a Starway Neo Occluder via a single-access approach: report of two cases

TL;DR

This case report describes a new minimally invasive technique for closing heart defects using a single catheter access point, showing promising early results in two patients.

Contribution

The paper introduces a novel transcatheter single-access approach for VSD closure, reducing procedural risks compared to conventional methods.

Findings

The single-access technique was successfully applied in two patients with stable device positioning confirmed by echocardiography.

Patients tolerated the procedure well with same-day ambulation and no major complications during early recovery.

Immediate and one-month follow-ups showed no residual shunt or valvular regurgitation.

Abstract

Ventricular septal defect (VSD) is among the most prevalent congenital heart diseases, accounting for approximately 20%–30% of cases. Mainstay treatments encompass interventional closure and surgical repair. The conventional interventional approach necessitates puncturing both the femoral artery and vein to establish an arteriovenous circuit for device delivery. While markedly less invasive than open-heart surgery, this method carries inherent risks, including sheath compression challenges, conduction block, injury to valvular chordae tendineae, and vascular complications.

To enhance procedural safety while maintaining efficacy, our center pioneered a transcatheter single-access closure technique for VSD, performed under fluoroscopic and echocardiographic guidance in two patients. This “single” strategy proved successful in both instances. The procedures were well-tolerated, with patients achieving ambulation on the same day, experiencing stable perioperative periods, and demonstrating favorable early recovery outcomes. Immediate and one-month follow-up transthoracic echocardiography confirmed stable device position, with no evidence of residual shunt or new-onset valvular regurgitation.

These case reports preliminarily indicate that the transcatheter single-access VSD closure technique is technically feasible and demonstrates a favorable early safety profile. While limited in scale, the successful outcomes in these two cases suggest significant promise for broader clinical adoption. However, further validation through larger-scale studies and long-term follow-up is required to confirm its sustained efficacy and safety.

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