{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:19:31Z","timestamp":1787552371040,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Transcatheter closure has become an important treatment modality for perimembranous ventricular septal defects (pmVSDs). However, conventional metallic occluders carry the risk of long-term complications. Fully bioabsorbable occluders offer a potential solution, yet their application in children with moderate-to-large pmVSDs remains under-reported. This study evaluated the feasibility and 1-year outcomes of transthoracic, transesophageal echocardiography (TEE)-guided implantation of a bioabsorbable occluder via a small subxiphoid incision in children with moderate-to-large pmVSDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children aged \u22651 year with moderate-to-large pmVSDs (defined as left ventricular defect diameter exceeding one-third of the aortic root diameter) who underwent TEE-guided transthoracic device closure using a bioabsorbable occluder between July 2024 and January 2025 were prospectively enrolled. Baseline characteristics, procedural data, and follow-up outcomes at 1, 3, 6, and 12 months were collected. The primary endpoints were technical success, valvular function, conduction disturbance, and occluder degradation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five children (mean age 2.4\u2009\u00b1\u20091.7 years; mean weight 12.6\u2009\u00b1\u20094.6\u2005kg; mean defect diameter 8.8\u2009\u00b1\u20092.6\u2005mm) were included. All implants were successful (technical success 100%). One patient with a multi-fenestrated defect had a 2\u2005mm residual shunt immediately post-procedure, which resolved by 6 months. At 1 year, no patient developed new-onset or worsening aortic regurgitation (AR) or tricuspid regurgitation (TR), and none had complete atrioventricular block (cAVB). Quantitative echocardiographic analysis showed that occluder disc area decreased substantially at 1 year, indicating progressive absorption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TEE-guided transthoracic closure of moderate-to-large pmVSDs using a bioabsorbable occluder appears feasible in selected children. One-year follow-up data suggest favorable preservation of valvular and conduction function, with progressive occluder degradation. This approach may offer a minimally invasive alternative to surgery for this challenging population, although larger studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1930121","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:30:58Z","timestamp":1787549458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and short-term outcomes of transcatheter closure of moderate-to-large perimembranous ventricular septal defects in children using bioabsorbable occluders: a prospective case series"],"prefix":"10.3389","volume":"13","author":[{"given":"Mai","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuliu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decai","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoxing","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoshi","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"393","DOI":"10.30476\/ijms.2024.102819.3595","article-title":"Short and mid-term outcomes of percutaneous perimembranous ventricular septal defect closure using amplatzer duct occluders type II in children and adolescents","volume":"50","author":"Amoozgar","year":"2025","journal-title":"Iran J Med Sci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2247","DOI":"10.1016\/j.jacc.2021.08.082","article-title":"Transcatheter closure of atrial and ventricular septal defects","volume":"79","author":"Turner","year":"2022","journal-title":"JACC Focus Seminar. 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