Transcatheter Closure of Membranous Ventricular Septal Defects-Old Problems and New Solutions.

Isolated perimembranous ventricular septal defect (VSD) is the most common congenital heart defect (after bicuspid aortic valve). Surgery is considered the gold standard for the treatment of these VSDs. However, it is associated with morbidity and mortality. Less invasive techniques have been developed, and percutaneous closure of perimembranous VSDs is now considered a possible alternative to the standard surgical approach. The main problem associated with transcatheter closure of VSD is the occurrence of complete atrioventricular block and need for pacemaker implantation. Improvements in technology and design will help to reduce the occurrence of this problem in the near future.