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Figure 1 Cine fluoroscopic images in a seven-month-old female baby with single muscular ventricular septal defect (VSD), demonstrating the steps of percutaneous device closure. (A) Left ventricular (LV) angiogram in the four-chamber view, demonstrating a 6-mm mid-muscular VSD (arrow). (B) Cine fluoroscopic image in the straight frontal projection, demonstrating the guide wire (arrow) across the VSD into the right ventricular (RV) and down the inferior vena cava. The wire was snared from there and exteriorized into the right internal jugular vein. (C) Delivery sheath with an 8-mm Amplatzer device inside (arrow), passing from the right internal jugular vein through the VSD and terminating into the LV. (D) The LV disk is being deployed and pulled against the septum (arrow). (E) Left ventricular angiogram confirms good LV disk position. (F) Cine angiogram after deployment of the connecting waist and RV disk (arrow). (G) Cine fluoroscopic image after the device was released. (H) Final LV angiogram confirming good device position and no residual shunting through the device.
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