Delayed Perventricular Device Closure of PostInfarction Ventricular Septal Defect Guided By Epicardial Echocardiography

Author(s): Pawel Czub, Karolina Zbikowska, Dobromila Dzwonkowska, Dariusz Zielinski, Beata Zaborska, Krzysztof Wrobel, Grzegorz Smolka

Open surgical repair or percutaneous transcatheter closure of postmyocardial infarction ventricular septal defect (PIVSD) still has an inhospital mortality of more than 40%. Transcatheter percutaneous repair of PIVSD is utilized in several clinical settings including acute stabilization as a bridge to surgery, correction of residual shunt after surgical repair, or as a primary modality of repair. Perventricular device closure (PVDC) of VSD under echocardiographic guidance is a hybrid approach successfully used in pediatric cardiac surgery. It was designed to combine the advantages of both approaches, allowing direct access to the defect without CPB but with guidance by transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE). It is a safe and easily reproducible technique that is acceptable in patients of any age, and suitable for most anatomical localizations.