Cardiac catheter guided surgical closure of an apical ventricular septal defect.

Surgical closure of muscular ventricular septal defects can be difficult. We report a technique in which a preoperatively placed cardiac catheter allowed accurate localization of a residual apical muscular defect at operation. The approach not only allowed improved visualization of the defect from the right side of the heart, but also helped to minimize the size of the left ventriculotomy required for satisfactory closure.