Percutaneous muscular ventricular septal defect closure with 2d transthoracic echocardiography: Can we sufficiently visualize it?

Ventricular septal defect (VSD) is one of the most common congenital heart diseases worldwide today. Although the majority close spontaneously, transcatheter VSD closure is a common option for symptomatic patients with suitable anatomy in adult age. Although transesophageal echocardiography (TEE) and intracar-diac echocardiography are the most common imaging modalities for the procedure, in patients with poor TEE images, Transthoracic echocardiography (TTE) can be used as a reliable alternative. Here we present an adult patient with pulmonary hypertension associated with a muscular VSD which was closed percutaneously using 2-dimensional TTE because of poor TEE images.