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Background Percutaneous device closure is being increasingly performed in the treatment of ventricular septal defect(VSD) at many institutions.In a minority of patients, a persistent residual left-to-right shunt is seen several months after the initial transcatheter VSD closure.Residual shunts following percutaneous VSD closure are clinically important.Such patients are at a higher risk of infective endocarditis.The best therapeutic approach to treat the residual shunt after device closure is unclear in clinical practice.