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We present a case of a 3.5-kg male newborn with transposition of the great arteries and 6-mm subpulmonary ventricular septal defect (VSD). On the ninth day after birth he had arterial switch surgery. However, VSD correction was unsuccessful (lack of proper visualisation of the defect and difficult access). In the postsurgical period heart failure worsening was observed due to significant left-to-right shunt. In order to delineate the exact anatomy of the defect, computed tomography was performed (Fig. 1). The heart team decided to close the defect in a hybrid approach. In the third month of life the 4.5-kg patient was readmitted. After sternotomy the right ventricular outflow tract was punctured on the beating heart under transoesophageal echocardiography guidance, which showed a 7-mm VSD located within 5 mm of the neoaortic valve (Suppl. Video 1—see journal website). The defect was crossed with a J-tip guidewire and, subsequently, an 8-F delivery sheath. Then, a 7-mm Hyperion™ VSDO Perimembranous Occluder was deployed (Comed BV, Netherlands/Lepu MT Company, China; size of symmetrical discs—11 mm, length of connecting waist—3.5 mm). Meanwhile, a short episode of two-to-one atrioventricular block (AVB) occurred, but the sinus rhythm recovered quickly. No neoaortic valve regurgitation occurred, but an insignificant residual leak was observed (Suppl. Video 2—see journal website). Taking into consideration previous difficulties with the VSD closure, the decision to release the implant was made (Fig. 2). Clinical improvement and no conduction disturbances in multiple 24-h Holter electrocardiography (ECG) recordings were …