Minimally Invasive Peratrial Device Closure of Perimembranous Ventricular Septal Defect Through a Right Infraaxillary Route: Clinical Experience and Preliminary.

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Minimally Invasive Peratrial Device Closure of Perimembranous Ventricular Septal Defect Through a Right Infraaxillary Route: Clinical Experience and Preliminary Results  Shubo Song, MD, Taibing Fan, MD, PhD, Bin Li, MD, Weijie Liang, MD, Haoju Dong, MD, Kaiyuan Wu, MD, Lin Liu, MD, PhD  The Annals of Thoracic Surgery  Volume 103, Issue 1, Pages 199-204 (January 2017) DOI: 10.1016/j.athoracsur.2016.05.069 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Delivery system and ventricular septal occluder. (A) Ventricular septal occluder; (B) loading sheath; (C) delivery sheath; (D) dilator sheath; (E) flexible guide wire; and (F) delivery cable. The Annals of Thoracic Surgery 2017 103, 199-204DOI: (10.1016/j.athoracsur.2016.05.069) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Hollow probes with different angles. The Annals of Thoracic Surgery 2017 103, 199-204DOI: (10.1016/j.athoracsur.2016.05.069) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Right infraaxillary incision (arrows): (A) preoperative incision; (B) postoperative incision. The Annals of Thoracic Surgery 2017 103, 199-204DOI: (10.1016/j.athoracsur.2016.05.069) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) Arterial blood spurting from the hollow probe. (B) Hollow probe crossing the defect (arrow). (C) The flexible guidewire (arrow) was sent to the left ventricle through the hollow probe, after which the hollow probe was removed. (D) The delivery sheath (arrow) was introduced over the guidewire into the left ventricular cavity. (E) Subsequently, the device was deployed. The left and right images for (C, D, and E) are the two-dimensional echocardiography and color Doppler flow imaging. (LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.) The Annals of Thoracic Surgery 2017 103, 199-204DOI: (10.1016/j.athoracsur.2016.05.069) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions