Catheter-based treatments for ventricular septal defects

Abstract Ventricular septal defects (VSDs) are a common form of congenital heart disease and those defects that do not close spontaneously often require intervention. While surgical closure of VSDs in the current era are associated with low morbidity and mortality, transcatheter-based approaches often avoid the need for a sternotomy, avoid the need for cardiopulmonary bypass, allow for shorter recovery times, and are potentially less costly. Percutaneous approaches, however, remain limited in smaller infants and children secondary to complicated wire and catheter courses that can result in hemodynamic instability, potential injury to heart valves or peripheral vasculature, and procedural failure. Intraoperative approaches, with and without the use of cardiopulmonary bypass, have also been described since 1993 [48] with procedural refinements and advances in device technologies allowing for improved outcomes over time. This chapter will discuss the history of device closure of perimembranous and muscular VSDs, as well as transcatheter and intraoperative closure in the current era.