Background: Transcatheter closure approaches of ventricular septal defects (VSDs) include anterograde through the right ventricle using an arteriovenous loop and retrograde transarterial approach. This systematic review assesses the outcomes and complications associated with transcatheter closure of VSD through a retrograde approach.

Methods: PubMed was searched for articles in English on retrograde closure of VSD from 2006 to 2024. The pooled estimates of success and complication rates were done by the random effects model.

Results: A total of 11 publications comprising 482 patients with variable types of VSD were included in this analysis. The pooled estimate of success was 89.3% (95% CI: 0.84-0.93). The most common complication is residual shunt pooled estimated is 7.1% (95% CI: 0.02-0.20). Others included valvular lesions pooled estimate is 6.4% (95% CI: 0.02-0.14), arrhythmias pooled estimate is 5.5% (95% CI: 0.02-0.12), conduction abnormalities pooled estimate rate is 5.3% (95% CI: 0.01-0.13), and death pooled estimated rate is 2.8% (95% CI: 0.08-0.07).

Conclusion: This analysis suggests that transcatheter retrograde closure of VSD is safe and effective with promising results. The limitations of this study are difficulties in analyzing the types of devices and VSDs individually. Clear inclusion and exclusion criteria including the patient’s age, weight, VSD type, and other features must be considered before proceeding with this approach.