Liu H, et al. - Researchers investigated the perioperative efficacy, safety and cardiorespiratory performance of perventricular closure of perimembranous ventricular septal defects (pmVSDs). For this purpose, they examined primary outcomes including complete closure at discharge, major and minor adverse events and the changes in perioperative cardiorespiratory performance from baseline among operation-naïve infants and young children aged 5–60 months with isolated pmVSDs who were randomised to receive either standard open surgical or minimally invasive perventricular closure via direct entry into the ventricle with a catheter from a subxiphoid incision. An attenuated rate of postoperative cardiorespiratory compromise was seen with perventricular closure vs surgical closure, however, interpreting non-inferiority regarding complete closure was recommended in the context of the specific population.