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 steps of the interventional
procedure. 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