Transcatheter device closure of congenital ventricular septal defects

Ventricular septal defects (VSD) are among the most commonly occurring congenital heart lesions. While successful surgical repair of VSDs has been possible for over 60 years, peri-operative and late complications still occur and there are inherent risks associated with sternotomy and exposure to cardiopulmonary bypass. A desire to avoid these risks, as well as the successful application of catheter-based device closure for other intracardiac and vascular shunting lesions, has lead to an interest in developing a less invasive means by which to close VSDs. The aim of this article is (a) to understand the important differences in approach to catheter-based closure of congenitally occurring VSDs, based on their location, (b) to discuss the technical aspects of device closure of VSDs, from both a percutaneous and perventricular (hybrid) approach, and (c) to review the outcomes of the experience with these devices. Acquired (post-infarction, post-trauma) VSDs will not be addressed.