Fig. 26.1
JR4 catheter coming from the aorta to the left ventricle, crossing VSD, and then from the right ventricle to the right atrium to the inferior vena cava
A 10-Fr sheath was brought over the Terumo wire to the level of the aortic valve (Fig. 26.2). This was used to advance the device. Device measurements were made based on echocardiographic measurements showing the largest diameter was 19 mm. This was then used to advance an Amplatzer 24-mm ASD device (Fig. 26.3). This was deployed (Fig. 26.4); however, it was found to be fully on the left ventricular side of the defect (Fig. 26.5).
Fig. 26.2
10-Fr sheath coming in from venous approach, with sheath and dilator sitting across aortic valve
Fig. 26.3
Device being advanced through sheath from venous approach. Notice the absence of wire in the aorta as this had to be sacrificed to advance the device
Fig. 26.4
Deployment of the 24-mm Amplatzer ASD device
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