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Key Points · Perventricular device closure of peri-membranous ventricular septal defects is safe and effective when compared to conventional surgery and transcatheter device closure. · Intraprocedural transesophageal echocardiography can effectively guide perventricular device closure of peri-membranous ventricular septal defects and improve safety and success rate. · Hybrid approach improves the outcomes in select patients with congenital heart diseases and complex anatomical defects.doi:10.22541/au.164339199.91583749/v1 fatcat:6npe6ejmcne3rh6quh6ffqekra