ABSTRACT
Introduction Currently, surgery and transcatheter techniques are employed for closure of ventricular septal defects (VSDs). With surgery, almost all perimembranous and most muscular VSDs can be closed, regardless of the patient’s size or weight. Muscular VSDs, however, have been a challenge to the surgeons because of their location and right ventricular trabeculations, and because the defects cannot be effectively closed through the right atrium, necessitating right or left ventriculotomy which is fraught with its own complications.1 Amongst the muscular VSDs, the apical and anterior muscular VSDs are difficult to visualize intra-operatively and, hence, closure is either incomplete or not possible.1,2 Surgical closure may be prolonged and this in turn increases the cardiopulmonary bypass (CPB) time, and its associated complications.3 On the other hand, transcatheter techniques are being employed with increasing frequency to close muscular and perimembranous VSDs.4 These techniques,with several advantages when compared to surgery, have limitations primarily because of patients’ weight and size. If the patient has concomitant cardiac defects, the defect may be closed in the operating room for obvious reasons.
