Word of Caution: Severe Aortic Valve Injury Linked to Retrograde Closure of Perimembranous Ventricular Septal Defects

Retrograde device closure of perimembranous ventricular septal defects (pmVSDs) is an interesting procedure with several technical advantages and encouraging follow-up results. Nevertheless, aortic valve injuries may occur and require sufficient attention. Herein, we report the first two cases of severe aortic regurgitation that we have linked to the retrograde pmVSD closure with the KONAR-MF (TM) VSD occluder. We detail the technical aspects, comprehensively discuss procedural errors and conclude with important learning points.