Procedures of PmVSD closure via ultra-minimal intercostal incision under the TEE guidance
A: A PmVSD (arrow) was found in the large artery short axial view on TEE.
B: The guidewire (arrow) was sent to the left ventricle through the PmVSD.
C: The delivery sheath and the dilator were introduced to the left ventricle over the guidewire. While the top of the sheath was confirmed to be in the left ventricle, the guidewire and the dilator were withdrawn and only the delivery sheath (arrow) was keep.
D: The short loading sheath loaded with the device was then connected to the long delivery sheath. The device was pushed to released the left disk (arrow) from the sheath.
E: The concentric occluder was placed in a proper position without residual shunt and influence on valve.
PmVSD: Perimembranous ventricular septal defect; TV: Tricuspid valve; LA: Left atrium;
LV: left ventricle;RV: Right atrium;AO: Aorta