Device closure of iatrogenic membranous ventricular septal defects after prosthetic aortic valve replacement using the Amplatzer membranous ventricular septal defect occluder.

Iatrogenic hemodynamically significant ventricular septal defects (VSDs) after aortic valve replacement are rare. The surgical risk to close such VSDs is substantial. Catheter closure has rarely been attempted because access to the left ventricle during cardiac catheterization in patients with a prosthetic aortic valve has been associated with a risk of catheter entrapment. We describe two cases of this rare entity after St. Jude and Medtronic valve replacement in which successful percutaneous closure of the iatrogenic VSDs was achieved using the Amplatzer membranous VSD occluder. Crossing the prosthetic valves with a delivery sheath and closure with the membranous VSD device was accomplished in both cases.