Failed transcatheter closure of ventricular septal defect with membranous septum aneurysm: report of one pediatric patient with literature review

Objective: To make a further understanding of ventricular septal defect (VSD) with membranous septum aneurysm, and to summarize the experience in performing transcatheter occlusion of VSD in vain. Methods: The clinical data of transcatheter occlusion treatment for ventricular membranous septum aneurysm in one pediatric patient were retrospectively analyzed, and the related literatures were reviewed. Results: Preoperative examination showed that this pediatric patient had no contraindications to transcatheter occlusion procedure. During the operation,three domestic VSD occluders with different diameters were used one after another to obstruct the VSD. The performance of occlusion procedure was tried for four times, but all were in vain. Through combination analysis of surgical results with the angiographic findings, the VSD lesion was finally proved to be the aneurysm of the membranous ventricular septum (AMS) type II. Conclusion: The aneurysmal sac of AMS is rather frail, therefore, the defect may be expanded by the transcatheter occlusion procedure. A full understanding of ventricular septal defect with membranous septum aneurysm and the improvement of the diagnostic accuracy of preoperative color Doppler echocardiography will be helpful in predicting the risk of surgery as well as in reducing the incidence of serious postoperative complications. (authors)