Jacqueline Saw, and Mathieu Lempereur JCIN 2014;7:

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Jacqueline Saw, and Mathieu Lempereur JCIN 2014;7:1205-1220 ACP/Amulet Implantation (A) Short- and (B) long-axis baseline TEE views showing measurements of the orifice (red arrows) and the landing zone (yellow arrows) at 10 mm (yellow line) within the orifice. Transseptal puncture in an inferior position on bicaval TEE view (C) and posterior position on short-axis TEE view (D). (E) Cineangiogram with marker pigtail in the LAA, and same measurements taken as with TEE. (F) TorqueVue 45 × 45 sheath is advanced with distal tip aligned with the landing zone. (G) First step of ACP/Amulet deployment is unsheathing to a “ball” configuration. (H) The remainder of the lobe is unsheathed and the position is checked on cineangiogram and TEE. (I) The disk is then unsheathed. (J) Device position is confirmed on TEE with color Doppler to assess leak. (K) Device is released and final cineangiogram performed. Abbreviations as in Figures 2 and 3. Jacqueline Saw, and Mathieu Lempereur JCIN 2014;7:1205-1220 American College of Cardiology Foundation