Case
Ten years old boy, operated for ventricular septal defect 3 years ago. He was presented with shortness of breath, getting tired early and grade 3 of a holosystolic murmur was detected. His chest X-ray showed moderate cardiomegaly. Two dimensional echocardiography demonstrated a large amount of shunt from the left ventricle to the right atrium. Left ventricle was dilated, therefore we decided to close the defect but the family refused to have a second surgery. Then we explained the percutaneous closure procedure to the family and they accepted. In catheterization; hemodynamic measurement showed an increase of oxygen saturation from the superior vena cava to the RA with a Qp/Qs ratio of 1.9. Left ventriculogram was done, Gerbode defect (LV to RA shunt) was shown. Narrowest diameter of the defect was 2mm, distance from aortic valve were measured as 6 mm. We have closed the defect with 4×4 Amplatzer duct occluder II(AGA Medical) device. Control LV angiogram was done, no residual defect was seen (Figure 1). Device location and its relation to aortic valve were also checked with transthoracic echocardiography. No rhythm disturbance was noticed during the procedure.
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