Ventricular septal defect (VSD) is one of the most common congenital heart malformation. As an isolated lesion, it accounts for 20%-30% of patients with congenital heart disease.1 Eighty percent of these defects are perimembranous involving the membranous septum and the adjacent area of muscular septum. At least 80% of these defects are small and close spontaneously,2,3 the larger defects often persist to cause significant shunt and right ventricular hypertension. Although conventional surgical repair of perimembranous ventricular septal defects (PMVSDs) is a safe, widely accepted procedure with negligible mortality. It is associated with morbidity, discomfort and a thoracotomy scar.1 As an altative to surgery, a variety of devices for transcatheter closure of VSD have been developed. However, these devices were not specifically designed for this purpose and none has gained wide acceptance. Large delivery sheaths, inability to recapture and reposition, structural failure, dislodgement and embolization of the device, interference with the aortic valve resulting in aortic insufficiency and a high rate of residual shunting are the major limitations of the previously described techniques.2,3 The initial experiences with transcatheter closure of PMVSDs in patients with a new device that was especially designed for non-surgical occlusion of these defects, the Amplatzer asymmetric VSD occluder (AAVSDO, AGA Medical Co., USA) were encouraging.4-6 But the long-term results are not known.