Percutaneous Closure of a Large Postinfarct Ventricular Septal Defect With an Atrial Septal Defect Closure Device in a High Surgical Risk Patient.

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.