Surgical VSD repair options

Are there any reliable non-open-heart surgical options
for repair of a multiple membraneous infundibular
vsd?

Also, with medial sternotomy, are there alternatives
to stainless steel twist wiring to approximate the sternum?
Seems like there ought to be by now -- we put a man on
the moon allegedly...

[CCF CARDIO MD JMF]

In response to your questions.

Are there any reliable non-open-heart surgical options
for repair of a multiple membraneous infundibular
vsd?  Given the multiple VSDs in your case, a clamshell device will likely not be an alternative.

Also, with medial sternotomy, are there alternatives
to stainless steel twist wiring to approximate the sternum?
Seems like there ought to be by now -- we put a man on
the moon allegedly...

there are now minimally invasive procedures that do not involve a stermotomy.  They might not be an alternative in your case depending on the extent and location of the VSD.