PMC4322409_01
Purse string taken over right atrial wall through the right sub-mammary incision
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F1
The right atrium (RA) was approached via a right sub-mammary incision in the right fifth intercostal space [Figure 1].
Puncture in the centre of the purse string suture through the intercostal space
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F2
The RA was punctured with Seldinger needle in the centre of the purse string suture through the intercostal space in the anterior axillary line away from the sub-mammary incision [Figure 2].
5 Fr JR catheter placed in LIPV
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F3
A Judkin's 5 Fr right coronary catheter was introduced into the left atrium (LA) and subsequently into the left inferior pulmonary vein (LIPV) [Figure 3].
8F TorqVue sheath being introduced over a superstiff wire into LA
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F4
Jude Medical, Plymouth, MN, USA) was passed over the super-stiff wire positioned in the LIPV [Figure 4].
Deployment of 18 mm ASO by pulmonary vein technique
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F5
An 18 mm Amplatzer septal occluder was delivered by the pulmonary vein deployment technique [Figure 5].
Final position of ASO after release
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F6
TTE [Figure 6].
Scar (measuring 2 cm) as seen on the first postoperative day
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F7
The sheaths were removed and RA puncture sight was closed with the purse string suture. The sub-mammary incision measuring 2 cm [Figure 7] was closed using absorbable suture.