ABSTRACT
Although a bicuspid aortic valve is the most common congenital cardiac anomaly, ventricular septal defects are the commonest anomalies managed by pediatric cardiologists and cardiac surgeons.1 They are most frequently located in the region of the membranous septum, but there are a number of anatomical variants. Because many VSDs have the potential to close spontaneously while others have the potential to cause pulmonary vascular disease, they present a challenge to the pediatric cardiologist and cardiac surgeon most importantly in the area of indications and timing of surgery. In contrast to surgical closure of an ASD, surgical closure of a VSD can present a number of technical challenges to the congenital cardiac surgeon. VSD closure by catheter delivered device continues to be associated with a high incidence of complete heart block and valve-related complications and is generally not recommended other than for midmuscular VSDs.
