Abstract
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 intracardiac 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.