Percutaneous Ventricular Septal Defect Closure

Percutaneous Ventricular Septal Defect (VSD) closure has become a viable alternative to surgery for certain perimembranous and most muscular ventricular septal defects. Various devices exist that cater to the unique anatomical variations in each patient. Given the variability in size and location of such defects, a detailed anatomical assessment is vital to allow the care team to make the most appropriate decision regarding surgical vs percutaneous VSD closure. Transthoracic echocardiography is essential in preprocedural planning, with transesophageal echocardiography playing an equally important intraprocedural role. Rarely, advanced cross-sectional imaging with a CT/MRI might be helpful in complex VSDs. In this chapter, we look at the standard transthoracic and transesophageal imaging assessment for percutaneous closure of perimembranous and muscular VSDs using a case-based illustrated approach.