This guidance replaces previous guidance on endovascular closure of perimembranous ventricular septal defect (interventional procedure guidance 172).
1.1 Current evidence on the safety and efficacy of transcatheter endovascular closure of perimembranous ventricular septal defect (VSD) is adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit.
1.2 Patient selection is important, especially in children and in asymptomatic patients, and should be carried out by a multidisciplinary team including an interventional cardiologist and a cardiac surgeon with specific expertise in the management of congenital heart disease.
1.3 When carried out on children, this procedure should only be undertaken in specialist paediatric cardiology units. For patients of all ages, this procedure should only be undertaken by cardiologists trained in the technique, including the management of complications. There should be access to emergency cardiac surgery by a surgeon experienced in the treatment of congenital heart disease.
1.4 Clinicians should enter details about all patients undergoing transcatheter endovascular closure of perimembranous VSD onto the UK Central Cardiac Audit Database.
1.5 NICE encourages publication of further long-term follow-up data, specifically on the occurrence of heart block compared with open surgery.