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Charanjit S. Rihal et al. JCIN 2012;5:121-130
Sequential Device Deployment With the Anchor Wire Technique (A) An extrasupport guidewire (arrowhead) is passed across the paravalvular defect, through the aortic valve, and is exteriorized through a femoral arterial sheath, creating an arteriovenous rail. An 8-F Flexor Shuttle sheath (Cook Medical) is advanced across the paravalvular defect (arrow). (B) A vascular plug (arrowhead) is deployed in the defect while the arteriovenous wire loop is maintained through the defect (arrow). (C) A second vascular plug is deployed (arrow) alongside the first device, leaving the arteriovenous loop in position (arrowhead). (D) Final position with 2 devices released (arrows) and the arteriovenous loop wire removed. See also Online Video 7. Charanjit S. Rihal et al. JCIN 2012;5: American College of Cardiology Foundation
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