Echocardiography plays a very important role in the diagnosis and
interventional management of ventricular septal defect (VSD).1 – 4
Until recently, transoesophageal echocardiography was considered
absolutely necessary for guiding transcatheter or per-ventricular
device placement, and, in the absence of reports to the contrary,
most physicians have viewed transthoracic echocardiography
(TTE) as unsuitable for this purpose.5 – 8 Because TTE also provides
an accurate and non-invasive definition of the VSD anatomy using
subcostal views in most children,9 – 11 we hypothesized that the
subcostal window could provide a suitable alternative for guiding
interventional device placement. This initial study assessed the
feasibility and efficacy of TTE-guided VSD periventricular device
closure.