Successful off-pump device closure of an isolated perimembraneous ventricular septal defect using a series of six occluders in a 5 kg infant via a minimally invasive approach.

摘要

A 3-month-old female of 5 kg presented with a 4.23 mm isolated perimembranous ventricular septal defect (pmVSD) which was confirmed by transoesophageal echocardiography (TEE) (Panel A). Before that, she had suffered from pneumonia twice. Systolic murmurs of Grade 3 could be heard in the third intercostal space, with intense pulmonary second heart sound. As determined with transthoracic echocardiography (TTE) analysis, the dimensions of the pmVSD were 4.5 mm, with enlarged left atria and ventricles. A 46 mmHg pulmonary artery systolic pressure was estimated by TTE. Cardiomegaly (cardiothoracic ratio: 0.65) and pulmonary congestion were demonstrated on chest X-ray film. All the above features strongly indicated early closure of the pmVSD.