Periventricular Closure of a Perimembranous VSD: Treatment Option in Selected Patients

Abstract

Ventricular septal defects (VSDs) are a common congenital heart disease. Usually, surgical repair with cardiopulmonary bypass (CPB) is the treatment of choice, whereas percutaneous techniques have technical limitations, predominantly a mismatch of catheter size and body weight. A 7-year-old girl underwent periventricular closure of a perimembranous VSD on the beating heart. Echocardiography guided implantation through a minimally invasive sternotomy was uneventful. The described approach adds favorably to the current practice avoiding the use of CPB. Cosmetic aspect and rapid early postoperative recovery are convincing.

Hybrid Technique for Muscular Ventricular Septal Defect Closure

“…We would not recommend this technique in children with mVSD without hemodynamically significant defects, as well as in patients who meet the criteria for percutaneous interventional closure. Despite the reports of successful hybrid perimembraneous VSD closure we would not recommend this technique in this setting until further randomized trials prove its efficacy …”

Intraoperative Device Closure of Subaortic Ventricular Septal Defects

“…A newly developed TEEG-PCDC has shown advantages over PTCC and may be an alternative to PTCC because of its visual control and accuracy. 1,2,3 The biggest advantage is that a shorter distance and directional performance can vertically advance the delivery sheath across the VSD and deploy a specially designed eccentric occluder ( Fig. 2A).…”

“…A new technique, percardiac device closure of intracardiac defects under transesophageal echocardiograhic guidance (TEEG-PCDC), has been established and considered as an alternative to repair of ventricular septal defects. 1,2,3 In this paper, we report the outcomes of this procedure in those ventricular septal defects (VSDs) immediately below the aortic valve.…”

Percutaneous-perventricular device closure of ventricular septal defect: mid-term follow-up.

“…Doubly committed subarterial ventricular septal defect (VSD) is a unique type of VSD accounting for about 5-7% of all VSDs [1] , which has been a contraindication for percutaneous transcatheter device closure due to the challenging geometry consisting of the upper edge of the defect and the aortic valve. Perventricular device closure of VSD without cardiopulmonary bypass (CPB) under transesophageal echocardiography (TEE) guidance has been widely practiced in China [2][3] , and was also used in some cases in Europe [4] . This technique has also been introduced recently in the treatment of doubly committed subarterial VSD with encouraging initial results and excellent cosmetic outcome [5][6][7] .…”