ArticleFrontiers in cardiovascular medicine2025
Case Report: Successful transcatheter repair of left ventricle-right atrium connection following ventricular septal defect surgery.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Left ventricle-right atrium (LV-RA) connection may develop secondary to ventricular septal defect (VSD) repair, particularly when the membranous septum or tricuspid valve is affected, leading to a leaflet defect. While surgery remains the standard treatment, reports of transcatheter valve closure are limited. This highlights the importance of exploring the safety and feasibility of transcatheter approaches for LV-RA connection, especially in high-risk patients. Case presentation: This is the first reported case of a retrograde Konar-MF closure of an LV-RA connection on a 6-year-old male patient with a history of VSD surgery. Pre-procedural transesophageal echocardiography (TEE) showed a 4 mm defect in the septal leaflet of the tricuspid valve. A residual membranous septal aneurysm (MSA) extending from the subaortic region to the septal annulus of the tricuspid valve without residual shunt, and a small atrial septal defect (ASD) were also identified. The cardiac team performed closure using Konar-MF VSD Occluder No. 6/8 mm via a retrograde right femoral arterial approach, advancing the catheter through the left ventricle and across the defect. A well-positioned device with minimal residual central shunt and without peripheral leakage were confirmed from the post-procedural TEE. Clinical evaluation immediately after procedure and at 3-month follow-up demonstrated good results. Conclusion: Percutaneous transcatheter device closure of an LV-RA connection in pediatrics is a feasible alternative to surgery using a retrograde technique.
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