Transcatheter closure of perimembranous ventricular septal defect (VSD) offers a minimally invasive alternative to surgery but carries a rare risk of atrioventricular block (AVB). This report describes 2 cases of conduction disturbances following transcatheter VSD closure and discusses their management. A 29-year-old man developed symptomatic high-grade AVB 5 days after successful device closure, which resolved with corticosteroid therapy and did not recur. A 25-year-old man developed new-onset left bundle branch block during device deployment using the retrograde approach; the procedure was aborted, and a subsequent closure with a smaller device positioned deeper within the septal aneurysm was successful without conduction issues. These cases emphasize the potential for conduction complications after transcatheter VSD closure and the importance of cautious device selection, meticulous deployment technique, and close rhythm surveillance. Early recognition and individualized management of AVB are key to achieving favorable outcomes.
Kwok et al. (2026) studied this question.