We report here the transcatheter closure of a large and complex post-myocardial infarction ventricular septal defect (VSD) involving the papillary muscle, measuring 38 mm in its greatest extent, too large to utilize a VSD occluder device (the largest VSD occluder is 24 mm). This necessitated the novel, off-label use of an atrial septal defect occluder instead.
Keywords: Amplatzer occluder device; percutaneous approach; post-MI VSD; transcatheter closure; ventricular septal defect repair.