4.4 Adverse events and complications
The major immediate procedure-related adverse events and complications, which related to include the closure procedure were: device dislocation, device embolization, left ventricular rupture or perforation, hemolysis, blood transfusion, arrhythmia, residual shunt. The complications not related to the procedure are as follows: multi-organ failure, respiratory(renal) and/or circulatory failure, cerebral infarction. In the final part of the Theses, Risseeuw writes: ” Procedure-related complications did not occur frequently and were rarely the direct cause of mortality, but mortality occurring in the long-term period following intervention was often the result of one of these complications[37].” Residual shunt as one of the relatively common complications was caused by progressive septal necrosis or other complications of relevance to device placement. It was qualitatively categorizing into trivial, mild, moderate and severe. Nevertheless, it is difficult to obtain a uniform standard due to empirical judgment with the naked eye. Recent evidence demonstrated that three-dimensional color Doppler echocardiography is a feasible method for quantifying the shunt volume in VSD patients[27], which had potential value on judging the indication of residual shunt need a secondary percutaneous procedure or surgical intervention. In order to reduce the occurrence of adverse events and complications, there is no doubt that the physicians should take care and comprehensive into consideration the medical conditions of patients to assess which is the best therapeutic decision.