Unveiling Success: A Case Report on the Challenges and Short Term Follow-Up of Post Transcatheter Subaortic VSD Closure

Abstract

Background: Due to the increased likelihood of aortic valve prolapse (AVP) and regurgitation, subaortic ventricular septal defects (VSD) are complex and present problems for maintaining aortic valve function. An alternative to surgery is transcatheter closure. However, careful monitoring for problems such as aortic regurgitation during short-term follow-up is essential.  Case Report: A 7-year-old girl, initially screened for heart disease, was diagnosed with subaortic VSD at a level III hospital and underwent successful transcatheter closure under general anesthesia. The transcatheter closure procedure was performed with retrograde transarterial technique under fluoroscopy and transoesophageal echocardiography guidance. No complication was found after the procedure and three months of follow-up.  Discussion: The case of subaortic VSD underscores the importance of prompt closure to prevent complications like aortic regurgitation and valve prolapse. While effective, transcatheter closure requires careful patient selection and intraprocedural assessment included echocardiographic guidance, careful device sizing, and fluoroscopic confirmation of sheath position to minimize risks. Equally crucial is the post-procedural phase, where careful monitoring, including echocardiography, is vital to evaluate occluder position, aortic regurgitation, and residual shunting. Conclusion: The retrograde transaortic technique has proven effective and safe for the transcatheter closure of subaortic VSD. The short-term follow-up, conducted 24 hours, two weeks, one month, and three months after the procedure, demonstrated no significant complications or adverse events, further affirming the procedure's safety and effectiveness.