Ventricular Septal Defects

Abstract

Percutaneous closure of ventricular septal defects is one of the biggest challenges in interventional cardiology. The defects that may be suitable for transcatheter closure are located within the muscular septum (muscular ventricular septal defects, MVSD) or in the perimembranous septum (perimembranous ventricular septal defects, PVSD) with or without aneurysm, and they can be native residual post-surgery. Surgical repair is currently the only option for doubly committed or supracristal defects, for perimembranous defects associated with prolapse of aortic valve and aortic regurgitation and for any defect associated with malalignment of the muscular outlet septum or straddling and overriding atrioventricular valves. Large defects give signs and symptoms of cardiac failure in early infancy, and they have to be treated surgically during the first months of life. The transcatheter closure can be done with an ante-grade approach. Alternatively, a retrograde or hybrid approach may be used. The procedure is safe and effective and major complications are rare.