Whether heart blocks post perimembranous ventricular septal defect device closure remain threatening: how could Chinese experiences impact the world?

Transcatheter closure has become one of the alternations of surgical treatment since 1988. However, cAVB occurred as a threatening incidence of 6.8% after Amplatzer VSD Occluder closure, which was quite higher than the incidence of 1% to 2% post-surgical closure, which leaded this kind of technique, was not approved by FDA. In this commentary, we reviewed the publications of cAVB following the device closure, and summarized current data of Modified Amplatzer-type Occluder during long-term follow-up, especially introduced the experiences from China, where this kind of treatment became a routine procedure for VSD children. Moreover, we carried our visualized analysis based on scientific literatures using CiteSpace to draw knowledge burst mapping, which revealed the development procedure on this interested topics, and demonstrated the role of China's works to make contributions in the field, and figured out the limitation of our researches, which supplied a basic understanding on why we could not impact the world. Finally, it concluded that transcatheter closure of pmVSD with Modified Amplatzer-type Occluder would be safe and efficient with low incidence of well controlled complications, but it failed to spread our experiences in a more scientific way. And, we hope this kind of therapy could be accepted in a wider region of the world with the increasing evidence from China.