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Peratrial Device Closure of Perimembranous Ventricular Septal Defects Through a Right Parasternal Approach  Li Hongxin, MD, Nan Zhang, MD, Guo Wenbin,

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Presentation on theme: "Peratrial Device Closure of Perimembranous Ventricular Septal Defects Through a Right Parasternal Approach  Li Hongxin, MD, Nan Zhang, MD, Guo Wenbin,"— Presentation transcript:

1 Peratrial Device Closure of Perimembranous Ventricular Septal Defects Through a Right Parasternal Approach  Li Hongxin, MD, Nan Zhang, MD, Guo Wenbin, MD, Wen-Long Zhang, MD, Zheng-Jun Wang, MD, Fei Liang, MD, Cheng-Wei Zou, MD  The Annals of Thoracic Surgery  Volume 98, Issue 2, Pages (August 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) The probe-assisted delivery system and (B) a Z-shaped hollow probe. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 A device stay suture of 4-0 or 5-0 polypropylene was passed through the wire mesh of the selected device under the microscrew and pulled out of the loading sheath (magnification of inset 2.5×). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) A right parasternal incision and (B) a lower median sternotomy incision. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 The Z-shaped hollow probe was inserted into the right atrium and advanced through the tricuspid valve into the right ventricle. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 The steps of peratrial device closure of a perimembranous ventricular septal defect. (A) An echocardiographic four-chamber view and (B) an aortic long-axis view were used to monitor the process of implanting the device (arrow). (C) The tip of the hollow probe (arrow) was adjusted to point to or cross the defect. (D) A flexible guidewire (arrowhead) was inserted into the channel of the probe and advanced through the defect into the left ventricle to establish a delivery pathway. The probe was withdrawn from the heart while maintaining the guidewire in its original position. (E) The delivery sheath was introduced through the defect over the wire and positioned with its tip in the left ventricular cavity. (F) The device was deployed subsequently. (AO = aorta; LV = left ventricle; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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