VSD closure device 2D and color still frame

Paired mid-esophageal apical four-chamber still frames with and without color Doppler imaging from intraoperative transesophageal echocardiogram (TEE). The images show a relatively empty heart on cardiopulmonary bypass during intraoperative placement of an Amplatzer muscular VSD device. The device has been positioned using a periventricular approach, introducing the sheath and later the device through the right ventricular wall using TEE guidance. The device (small arrows) is well seated on the septum and remains attached to the delivery cable (large arrow) at this point in the procedure. Color Doppler imaging has been utilized to show that the previously present muscular VSD is essentially occluded by the device.