Modified Arteriovenous Loop Technique for Successful Antegrade Device Closure of Perimembranous Ventricular Septal Defects with Aortic Valve Prolapse-A Single-Center Experience.

In ventricular septal defects (VSDs) close to aortic valve, mostly surgical closure is preferred. Currently, transcatheter method of device closure is done in selective cases with satisfactory results. Perimembranous with outflow extension VSDs having mild aortic valve prolapse with trivial to mild aortic regurgitation (AR) were selected. VSD devices were deployed through antegrade route with our modification of standard arteriovenous (A-V) loop technique to prevent aortic valve compression and progression of AR. Among 55 cases of perimembranous VSDs having outlet extension with aortic valve prolapse, 44 (80%) cases had successful closure with our modified technique and 11 (20%) underwent surgical closure as device closure was not amenable. At 1 year follow-up, the VSD closure rate was 91% with trivial and mild AR persisting in 24.4% and 5% of cases, respectively. Satisfactory closure of VSDs close to aortic valve is possible with our modified A-V loop technique.