Ventricular septal defects are the most common congenital heart defects. They account for approximately 20% of all forms of congenital heart disease as an isolated lesion. Perimembranous Ventricular septal defects are the most common form (70%), followed by muscular (15–20%).Muscular VSDs are a challenging problem in neonates and infants when they present with significant congestive heart failure from interventricular shunting. However, with careful adjustments to technique, most of these can be closed.