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.