Transcatheter ventricular septal defect closure: Should we feel comfortable after many years?

Ventricular septal defect (VSD) is the most common congenital heart defect. Indicated closure is performed either by surgery or by using a transcatheter route in eligible patients (1). Although closure rates are similar in the transcatheter and surgical VSD closure, both the transcatheter closure of a VSD and surgery are not a complication-free procedure (2, 3). The occurrence of a complete atrioventricular block (CAVB) is one of the major complications of transcatheter closure, particularly in perimembranous-type VSDs. CAVB may occur acutely during the procedure or after a few days or months of the transcatheter closure (3-8). Late development of CAVB is an alarming complication because of the risk of sudden death. According to our knowledge, the longest interval between the procedure and the occurrence of CAVB in the literature is 20 months (5). Herein, we report the case of an 8-year-old girl who developed CAVB at 51 months after an uneventful closure of muscular VSD located just below the membranous septum (known as high-muscular VSD).