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Volume 4, Issue 3, Pages 114-117 (March 2019) Use of a cardiac septal occluder in the treatment of a chronic GI fistula: What should we know before off-label use in the GI tract? Diogo Turiani Hourneaux de Moura, MD, MSc, PhD, Pichamol Jirapinyo, MD, MPH, Kelly E. Hathorn, MD, Christopher C. Thompson, MD, MHES VideoGIE Volume 4, Issue 3, Pages 114-117 (March 2019) DOI: 10.1016/j.vgie.2018.10.011 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 External cutaneous fistula orifice. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Endoscopic visualization of the esophageal fistula. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Ventricular septal defect occluder device. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Ventricular septal defect occluder device attached to delivery system. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Introduction of the delivery system into the cutaneous orifice. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Endoscopic visualization of the cardiac septal defect occluder device closing the defect. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 7 Fluoroscopic image of the cardiac septal defect occluder device after deployment. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 8 Fluoroscopic image demonstrating no extravasation of contrast material through the cardiac septal defect occluder device. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 9 Follow-up barium swallow demonstrating no extravasation of contrast material after oral ingestion. VideoGIE 2019 4, 114-117DOI: (10.1016/j.vgie.2018.10.011) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions