Vol. 43 | No. 1 | January-June 2015 Back

Open Access

Comparison of the Clinical Outcomes and Costs Between Transcatheter Device Occlusion and Surgical Closure for the Treatment of Isolated Ventricular Septal Defect

Bernadette B. Valdez, Juan G. Reganion, Jean Antonio G. Villareal
Jun 2015 DOI 10.69944/pjc.269180b188

Abstract

INTRODUCTION: The most common congenital heart disease (CHD) in childhood is ventricular septal defect (VSD), and the standard mode of treatment for defects that need correction is surgical closure under cardiopulmonary bypass. Advancements in technology are leading us into the era of percutaneous closure of VSDs. The current trend in the correction of CHD is to use techniques that would allow early hospital discharge and come with the least morbidity risk. The objective of this study was to compare the costs and the clinical outcomes of transcatheter device occlusion and surgical closure as modes of treatment for isolated VSD among pediatric patients of the Philippine Heart Center (PHC). 

METHODOLOGY: This was a prospective cohort study of pediatric patients who underwent either device occlusion or surgical closure of uncomplicated VSD in PHC from January 2014 to December 2014. Complications that occurred immediately after the procedure, during the hospital stay and one month after discharge were compared. The lengths of post-procedural hospital stays were likewise compared. Actual in hospital charges and costs of complications during the hospital stay were noted. 

RESULTS: All cases of VSD that were included in the study were closed successfully with no residual shunts for either group. The complications noted were blood loss requiring blood transfusion (22.6% for the surgical group, 12.9% for the device group), procedure-related infection (12.9% for the surgical group; 0% for the device group) and pneumothorax (12.9%, surgical group; 0%, device group). The mean post-procedural days were 4.7 for the surgical group and 1.2 for the device group (p<0.001); the mean post-procedural days for patients with complications in the surgical group was about seven days. There was a significant difference in the hospital and procedural costs between the two groups, i.e., the surgical group’s expenses were greater by ₱75,200.00 (p<0.001). 

CONCLUSION: The results of this study support the continued use of transcatheter occlusion as a treatment option for the closure of isolated VSD. 

KEYWORDS: ventricular septal defect, transcatheter closure of VSD.

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