Ventricular septal defects (VSDs) are a common congenital heart disease. Usually, surgical repair with cardiopulmonary bypass (CPB) is the treatment of choice, whereas percutaneous techniques have technical limitations, predominantly a mismatch of catheter size and body weight. A 7-year-old girl underwent periventricular closure of a perimembranous VSD on the beating heart. Echocardiography guided implantation through a minimally invasive sternotomy was uneventful. The described approach adds favorably to the current practice avoiding the use of CPB. Cosmetic aspect and rapid early postoperative recovery are convincing.
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