Figures legends
Figure 1 . Two-dimensional transesophageal echocardiography
(TEE) image showing a large ventricular septal rupture 28 mm in diameter
(bracket) located at the infero-posterior septum.
RV: right ventricle; LV: left ventricle; LA: left atrium
Figure 2 . Two-dimensional transthoracic echocardiography (TTE)
apical four-chamber (A,B ) and short-axis color Doppler
(C,D ) views showing post-surgical ventricular residual rupture
18,6 mm in diameter (yellow arrow) with left-to-right shunt (white
arrow).
RV: right ventricle; LV: left ventricle
Figure 3 . Fluoro-angiographic procedural steps. A : An
arteriovenous rail established using a retrograde arterial approach
(left femoral artery) with a 5F multipurpose catheter and a Terumo wire
that was advanced through the septal rupture into the inferior vena
cava, where it was snared via the right femoral vein; B-D : the
24 mm PIVSR occluder (black arrows) delivered through the dedicated
delivery system (arrowhead) across the septal rupture; the welded ball
of the device is secured to the dedicated delivery system (white arrow);E : zoom fluoro image showing the device deployment: the welded
ball (white long arrow) is no more attached to the dedicated Flex Pusher
II delivery system; two radiopaque gold markers are clearly seen on the
distal disc. F : final LV angiogram showing a stable device
position with mild residual left-to-right shunt.
Figure 4 . Two-dimensional transthoracic echocardiography (TTE)
at 6-month follow-up. Apical four-chamber (A ) and short-axis
color Doppler (B-C ) views showing the 24-mm PIVSD occluder in
situ (yellow arrow) with trivial residual left-to-right shunt.
RV: right ventricle; LV: left ventricle.