Transcatheter closure of a perimembranous ventricular septal defect in isolated dextrocardia

Percutaneous closure of a perimembranous ventricular septal defect (VSD), indicated because of progressive tricuspid regurgitation secondary to the chronic left-to-right shunt, was performed in isolated dextrocardia. It was possible to cross the VSD from the left ventricle with a right Judkins catheter and establish an arteriovenous circuit using a Terumo™ wire and a goose neck snare. The guiding sheath was brought in stable position in the left ventricular outflow tract in a close position with the arterially advanced pigtail catheter. A major limitation to percutaneous VSD-closure still remains young age and the corresponding low weight of children requiring early VSD-closure because of heart failure and pulmonary hypertension.