1. Thomas E. Fagan, MD University of Colorado Aurora, Colorado SCAI Fellows Course, Las Vegas, Dec ‘12 ASD Closure Case

2. Ÿ 4 yr old female Ÿ At least 2 ASDs - 6 mm + 4 mm Ÿ Moderate RV enlargement Ÿ Pulmonary valve dysplasia - Peak velocity 2.4 m/sec ASD Closure Clinical Background

3. Ÿ Normal right heart pressure Ÿ Qp : Qs = 1.9 : 1 Ÿ No significant pulmonary valve gradient Ÿ TEE; Two ASDs - 9 mm superior - 5 mm inferior ASD Closure Clinical Background

4. ASD Closure Clinical Background

5. ASD Closure Clinical Background Options???

6. ASD Closure Clinical Background

7. ASD Closure Double HELEX Delivery

8. ASD Closure Double HELEX Delivery

9. ASD Closure Double HELEX Delivery

10. ASD Closure Double HELEX Delivery

11. ASD Closure Double HELEX Delivery

12. ASD Closure Double HELEX Delivery

13. ASD Closure Double HELEX Delivery

14. ASD Closure Double HELEX Delivery

15. Thank You thomas.fagan@ childrenscolorado.org