A novice’s approach to a ventricular septal rupture closure with an atrial septal device

Abstract

We describe here an approach to a ventricular septal rupture in a patient with a recent myocardial infarction. We briefly describe how we decided the route, the type of device and the procedure we followed. We also detail how we followed up the patient. We performed the VSR closure 5 days after the index infarction as the patient was in hypotension. The ventricular septal rupture was crossed with a Terumo wire covered by a right coronary guide catheter passing from the left ventricle to the right ventricle via a right femoral artery approach and the right internal jugular vein was used to form an arteriovenous loop. Using a patent ductus arteriosus sheath the ventricular septal rupture was crossed and a 16 mm Amplatzer ASD closure device was deployed. The patient had a mild residual leak and tolerated the procedure well.We have also included a few words from various authors who have attempted VSR closure including some from 2019.