title: Epicardial deployment of right ventricular disk during perventricular device closure in a child with apical muscular ventricular septal defect.
abstract: We report a successful perventricular closure of an apical muscular ventricular septal defect (mVSD) by a modified technique. An eight-month-old infant, weighing 6.5 kilograms, presented with refractory heart failure. The transthoracic echocardiogram showed multiple apical mVSDs with the largest one measuring 10 mm. perventricular device closure using a 12 mm Amplatzer mVSD occluder was planned. The left ventricular disk was positioned approximating the interventricular septum; however, the right ventricular (RV) disk was deployed on the free wall of the RV due to an absent apical muscular septum and a small cavity at the apex. The RV disk of the device was covered using an autologous pericardium. His heart failure improved during follow-up.
authors.affiliation: Department of Pediatric Cardiology, Care Hospital, Hyderabad, India.
authors.forename: Nageswara Rao
authors.initials: NR
authors.lastname: Koneti
authors.affiliation: Department of Pediatric Cardiology, Care Hospital, Hyderabad, India.
authors.forename: Sudeep
authors.initials: S
authors.lastname: Verma
authors.affiliation: Department of Pediatric Cardiology, Care Hospital, Hyderabad, India.
authors.forename: Shweta
authors.initials: S
authors.lastname: Bakhru
authors.affiliation: Department of Pediatric Cardiology, Care Hospital, Hyderabad, India.
authors.forename: Karunakar
authors.initials: K
authors.lastname: Vadlamudi
authors.affiliation: Department of Pediatric Cardiology, Care Hospital, Hyderabad, India.
authors.forename: Pallavi
authors.initials: P
authors.lastname: Kathare
authors.affiliation: Department of Pediatric Cardiac Surgery, Care Hospital, Hyderabad, India.
authors.forename: Br
authors.initials: B
authors.lastname: Jagannath
keywords: Hybrid muscular ventricular septal defect closure; muscular ventricular septal defect occluder; perventricular device closure