Under general anaesthesia, patients received a probe placed below
the xiphoid process to guide the whole procedure. The size of the
occluder was determined on the basis of the maximal measured diameter
by TTE plus 1 – 2 mm. An incision of 2 – 3 cm in length was made
in the lower sternum to expose the right ventricle, and heparin (1 mg/kg)
was then administered. The location of the puncture was determined
by protruding the right ventricle towards the VSD guided by TTE. The
right ventricular-free wall was punctured using a trocar, and then a
floppy guide wire was inserted and advanced to cross the VSD into
the left ventricle under TTE guidance (Figure 3). An appropriately
sized delivery sheath was advanced along the wire into the left
ventricle (Figure 4), and TTE subcostal views were used to make
sure the wire and sheath were directed through the VSD into the
left ventricle. The VSD occluder was screwed into the delivery
cable, and the device was loaded and introduced into the delivery
sheath and then advanced to the tip of the sheath. Before release,
TTE subcostal views were used to evaluate the device position
Under general anaesthesia, patients received a probe placed belowthe xiphoid process to guide the whole procedure. The size of theoccluder was determined on the basis of the maximal measured diameterby TTE plus 1 – 2 mm. An incision of 2 – 3 cm in length was madein the lower sternum to expose the right ventricle, and heparin (1 mg/kg)was then administered. The location of the puncture was determinedby protruding the right ventricle towards the VSD guided by TTE. Theright ventricular-free wall was punctured using a trocar, and then afloppy guide wire was inserted and advanced to cross the VSD intothe left ventricle under TTE guidance (Figure 3). An appropriatelysized delivery sheath was advanced along the wire into the leftventricle (Figure 4), and TTE subcostal views were used to makesure the wire and sheath were directed through the VSD into theleft ventricle. The VSD occluder was screwed into the deliverycable, and the device was loaded and introduced into the deliverysheath and then advanced to the tip of the sheath. Before release,TTE subcostal views were used to evaluate the device position
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