Sample Solution

In most centers, the procedure is approached using antegrade or transvenous method by creating an arteriovenous guide wire loop; which is the standard technique for transcatheter VSD device closure. Some studies have described that retrograde method and transarterial approach cannot be performed due to technical difficulties, mostly in adult patients. Recent studies of using variety of Amplatzer occluder devices had been successful with retrograde technique in adolescents and children with congenital VSD. Retrograde technique involves fewer steps and possesses the potential to significantly reduce fluoroscopy and total procedure time in comparison with the conventional methods. In a case series of Pekel et al. presented their experience of the transcatheter VSD closure using transarterial retrograde approach and concluded that it simplifies the procedure, decreases the radiation exposure, and shortens the procedure time.13 After a thorough literature search, no local study on transcatheter device closure of VSD comparing the two techniques was published.
Early in this institution, most patients with ventricular septal defect that undergo transcatheter technique still use the conventional method (transvenous antegrade approach). Only ten years ago, transcatheter closure using implantable devices has been introduced and is recently gaining popularity. When explaining the therapeutic options to the patients or the parents with VSD, outcome goals and complications or adverse events should be fully discussed. Since transcatheter device closure of VSD is an evolving technology, data on effectiveness, cost and mid-term outcome comparing these two technique