Closing the gap: Navigating the percutaneous path for a 2-month-old infant\'s perimembranous ventricular septal defect

Abstract

Ventricular septal defects (VSDs) represent a substantial portion of congenital heart diseases, with perimembranous VSD (pmVSD) being the most prevalent variant. While surgical closure is conventional, it carries risks such as atrioventricular block, infection, and neurological issues. In contrast, catheter-based interventions have shown promise, particularly for muscular VSDs, but data for pmVSD closure remains limited. We present a case of a 2-month-old male infant referred for heart failure symptoms, characterized by a grade 3/6 pan systolic murmur and mild cardiomegaly on chest X-ray. Echocardiography revealed a 5.5 mm pmVSD with a peak gradient of 32 mm of Hg and pulmonary artery systolic pressure of 10 mm of Hg. Despite de-congestive therapy, the patient showed no symptomatic improvement, prompting consideration of percutaneous device closure due to the infant's low body weight (3 kg) and failure to thrive.This case report discusses the successful percutaneous closure of a perimembranous ventricular septal defect (pmVSD) in the youngest patient ever recorded. It highlights the effectiveness of transcatheter techniques in managing congenital heart defects in young patients.