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Karim A. Diab, MD, Ziyad M. Hijazi, MD, Qi-Ling Cao, MD, Emile A

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Presentation on theme: "Karim A. Diab, MD, Ziyad M. Hijazi, MD, Qi-Ling Cao, MD, Emile A"— Presentation transcript:

1 A truly hybrid approach to perventricular closure of multiple muscular ventricular septal defects 
Karim A. Diab, MD, Ziyad M. Hijazi, MD, Qi-Ling Cao, MD, Emile A. Bacha, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 130, Issue 3, Pages 892.e1-892.e3 (September 2005) DOI: /j.jtcvs Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Cineangiographic images in the hepatoclavicular position demonstrating closure procedure. A, Cineangiographic image after Amplatzer Duct Occluder (black arrow) has been released and anterior muscular VSD has been crossed from the left side with wire positioned in the left PA (white arrow). B, Hand-injection angiogram in the main PA through a delivery sheath (short arrow) passed from the RV free wall to the main PA (long arrow showing a red rubber tourniquet used for the purse-string suture). C, Cineangiographic image during snaring of wire from the PA inside the delivery sheath (arrow). D, Cineangiographic image during deployment of the RV disk (arrow). The LV disk is already deployed. The device is inserted through the RV free wall. The Journal of Thoracic and Cardiovascular Surgery  , 892.e1-892.e3DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

3 Figure E1 TEE images in four-chamber views (except H) demonstrating the closure procedure. A, Demonstrates two defects, near the apex and more midanterior (arrows). B, Puncture of the RV free wall with an 18-gauge needle (arrow). C and D, Passage of the guide wire (C) and delivery sheath (D) through the apical VSD to the LV cavity. E, Amplatzer Duct Occluder was released, demonstrating good position. F, Color Doppler demonstrates a large residual shunt from the anterior VSD. G and H, After the Amplatzer muscular VSD device has been released, both devices (arrows) are in good position. The Journal of Thoracic and Cardiovascular Surgery  , 892.e1-892.e3DOI: ( /j.jtcvs ) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

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