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Published online by Cambridge University Press: 30 July 2025
Transcatheter device closure of a large perimembranous ventricular septal defect with left-to-right shunt was attempted with an antegrade transvenous approach and a conventional arteriovenous loop facilitated, both of which were unsuccessful. We succeeded with an indigenous technique of advancing the delivery sheath towards the left ventricular apex from the venous side with the help of a cut pigtail, keeping the arteriovenous loop.