Successful Closure of a Ventricular Septal Defect Using a Novel Non-Prosthesis Touching Technique Following Mechanical Aortic Valve Replacement.

Percutaneous intervention is preferred over reoperation for the treatment of iatrogenic membranous ventricular septal defects (VSDs). During the standard percutaneous procedure, an arterio-venous loop is used for occluder deployment, entailing the risk of device impingement on the prosthetic aortic valve, which may cause serious complications or even death. In this report, we describe a novel non-prosthesis touching procedure for the closure of a VSD in a patient with prior aortic valve replacement. The unique feature of this technique is the use of an apex-venous loop for occluder deployment, which prevents the device impingement on the prosthetic valve, thus avoiding difficulties, lengthy operation and serious complications associated with the standard procedure. Immediate and 1-year follow-up results showed that the VSD was successfully closed and no serious complications were observed.