Percutaneous closure of ventricular septal defect with the KONAR-MF device

Introduction and objectives: Percutaneous closure of ventricular septal defect (VSD) can be an alternative to surgery reducing length of stay, and complications. The high risk of atrioventricular block (AVB) involved during percutaneous closure has encouraged the development of new devices such as the KONAR-MF (Lifetech, China). This device is very flexible and has a low radial force that adapts to the anatomy of the VSD without exerting any pressure to the adjacent structures. This is our early experience with this new device. Methods: Retrospective review of patients and VSD closure procedures using the KONAR-MF device at 2 Spanish centers from February 2020-date of the first implantation in our country-through September 2021. Results: A total of 7 closure procedures of VSD were performed being the device successfully implanted in 6 of the 7 patients. A total of 4 native perimembranous VSDs and 3 residual VSDs after tetralogy of Fallot repair were reported. The size of the VSD measured through transesophageal echocardiography and angiography was consistent in all the cases except for 1. In this patient device embolization occurred. At the follow-up [1.2 months (IQR, 0.9-15.5), (maximum 17 months)] we saw worsening atrioventricular conduction in a patient with a previous AVB who required a pacemaker. The immediate residual shunt rate was 83% (5/6) with persistent residual shunt beyond the 1-month follow-up in 1 patient (16%). All patients were discharged from the hospital within the first 48 hours following the intervention. Conclusions: The percutaneous closure of VSD with the KONAR-MF device is a feasible alternative to surgery in selected patients. An adequate anatomical evaluation of the VSD is one of the keys of successful procedures. The implantation of this device is no stranger to complications like AVB or device embolization.