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Endoscopic Closure of Iatrogenic Ventricular Septal Defect After 2 Previous Aortic Valve Replacements
Abdelrahman Abdelbar1, Simran Kundan2, Andrew Knowles2
1Cardiac Surgery Department, Manchester Foundation Trust, Manchester, United Kingdom.
JACC. Case Reports
|July 18, 2025
Summary
This case report details the first endoscopic closure of an iatrogenic ventricular septal defect in a patient with complex cardiac history. This minimally invasive approach offers a viable alternative to sternotomy for redo cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Interventional Cardiology
Background:
- A 79-year-old male with a history of two aortic valve replacements via median sternotomy presented with dyspnea.
- The patient developed an iatrogenic perimembranous ventricular septal defect post-procedure.
Observation:
- Transthoracic echocardiogram confirmed the ventricular septal defect.
- A heart team determined the defect was unsuitable for percutaneous closure.
Findings:
- Endoscopic minimally invasive surgical closure of the iatrogenic ventricular septal defect was successfully performed.
- The patient experienced a rapid recovery following the procedure.
Implications:
- This represents the first reported case of endoscopic closure for an iatrogenic ventricular septal defect.
- Endoscopic approaches are feasible and beneficial for complex redo cardiac surgeries, potentially avoiding repeat sternotomies.
- Heart teams should consider endoscopic closure for complex cases lacking interventional options.
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