{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:53:42Z","timestamp":1792198422578,"version":"4.4.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The complex anatomy of DCSA VSD, its proximity to valvular and conduction tissues, and concerns about radiation and contrast make transcatheter closure particularly challenging in pediatric patients. While zero-fluoroscopy closure was not achievable in this case, we successfully performed zero-contrast transcatheter closure in a baby weighing less than 10\u2005kg. This report highlights the feasibility and early outcomes of this approach at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case illustration<\/jats:title><jats:p>An 18-month-old, 9\u2005kg boy with a history of feeding difficulties, failure to thrive, and breathlessness since 14 days of age underwent transcatheter closure of a doubly committed subarterial (DCSA) ventricular septal defect (VSD). Transthoracic echocardiography revealed a 4\u20135\u2005mm left-to-right shunting VSD with preserved ventricular function. Initial attempts to cross the VSD under zero-fluoroscopy guidance using various catheters were unsuccessful, necessitating fluoroscopic assistance without contrast. A Konar-MF VSD occluder (7\/5\u2005mm) was successfully deployed retrogradely, achieving complete defect closure with no residual shunt or valve dysfunction. Post-procedure, the patient remained asymptomatic, with excellent device positioning and no complications noted at follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case demonstrates the feasibility of zero-contrast percutaneous DCSA-VSD closure in selected patients weighing less than 10\u2005kg. Further studies are needed to validate its safety and long-term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1564232","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:52:13Z","timestamp":1751435533000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Zero contrast technique in doubly committed subarterial ventricular septal defect closure in patient with body weight less than 10\u2005kg: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Radityo","family":"Prakoso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Ariani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya Agita","family":"Sembiring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Mendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oktavia","family":"Lilyasari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"E295","DOI":"10.1002\/ccd.28678","article-title":"Percutaneous closure of restrictive-type perimembranous ventricular septal defect using the new KONAR multifunctional occluder: midterm outcomes of the first middle-eastern experience","volume":"96","author":"Haddad","year":"2020","journal-title":"Catheter Cardiovasc Interv"},{"key":"B2","doi-asserted-by":"publisher","first-page":"100081","DOI":"10.1016\/j.ijcchd.2021.100081","article-title":"Transcatheter closure of doubly committed subarterial ventricular septal defect: early to one-year outcome","volume":"2","author":"Kuswiyanto","year":"2021","journal-title":"Int J Cardiol Congenit Heart Dis"},{"key":"B3","first-page":"65","article-title":"Percutaneous closure of ventricular septal defects in children: key parameters affecting patient radiation exposure","volume":"11","author":"Haddad","year":"2021","journal-title":"Am J Cardiovasc Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1186\/s40001-023-01398-8","article-title":"Percutaneous closure of simple congenital heart diseases under echocardiographic guidance","volume":"28","author":"Jiang","year":"2023","journal-title":"Eur J Med Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1093563","DOI":"10.3389\/fcvm.2023.1093563","article-title":"Transesophageal echocardiography-guided percutaneous closure of multiple muscular ventricular septal defects with pulmonary hypertension using single device: a case report","volume":"10","author":"Siagian","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"885140","DOI":"10.3389\/fcvm.2022.885140","article-title":"Echocardiography-guided percutaneous patent ductus arteriosus closure: 1-year single center experience in Indonesia","volume":"9","author":"Siagian","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2665","DOI":"10.1007\/s42399-021-01062-4","article-title":"Potency of non-fluoroscopy guided patent ductus arteriosus closure: a case report","volume":"3","author":"Mendel","year":"2021","journal-title":"SN Compr Clin Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1186\/s12872-024-04165-7","article-title":"Echocardiography-guided percutaneous closure of oval-shaped secundum atrial septal defects","volume":"24","author":"Siagian","year":"2024","journal-title":"BMC Cardiovasc Disord"},{"key":"B9","doi-asserted-by":"publisher","first-page":"5222","DOI":"10.21037\/jtd.2018.08.03","article-title":"Transcatheter perimembranous ventricular septal defect closure under transthoracic echocardiographic guidance without fluoroscopy","volume":"10","author":"Wang","year":"2018","journal-title":"J Thorac Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"101052","DOI":"10.1016\/j.ijcha.2022.101052","article-title":"Absolute zero-contrast percutaneous coronary intervention under intravascular ultrasound guidance in chronic kidney disease patients - from despair to hope?","volume":"40","author":"Kumar","year":"2022","journal-title":"Int J Cardiol Heart Vasc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s00246-023-03358-9","article-title":"Utility of Konar-multifunctional occluder in complex situations: unconventional uses in rare situations","volume":"45","author":"Kamran","year":"2024","journal-title":"Pediatr Cardiol"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1564232\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:52:16Z","timestamp":1751435536000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1564232\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,2]]},"references-count":11,"alternative-id":["10.3389\/fcvm.2025.1564232"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1564232","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,2]]},"article-number":"1564232"}}