Page 36 - Journal of Structural Heart Disease Volume 2, Issue 1

Original Research Report
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Middle frame: The balloon is in ated followed by sequential release of the left atrial disk, waist and the right atrial disk (Video 41).
Right frame: The balloon is gradually de ated to allow deployment of the device across the ASD (Vid- eo 42). The advantages of BAT are that it is a simple and safe procedure, is e ective across all ages, has a short learning curve and is predictable. Its limitations include requiring an additional venous access, addi- tional hardware (cost), need for additional person- nel, large venous access and problems pertaining to hemostasis.
Slide # 55:
Left frame: The balloon catheter is pulled back into the inferior vena cava before releasing the device (Video 43).
Middle frame: The Supersti wire now pulled back into the inferior vena cava before releasing the device (Video 44).
Right frame: Device position con rmed in left an- terior oblique view and released (Video 45).
Slide # 57:
BAT modi cation by Kammache et al. [20]:
Major di erences in this modi ed technique in- clude:
1. The sizing balloon (Meditech, Boston Scienti c, Watertown, Massachusetts, USA) is positioned in the septal defect or even within the left atrium in order to use it as a rim to anchor the device.
2. The left atrial disk is delivered in the left atrium rather than just outside the superior pulmonary vein.
3. The authors recommend gentle tug on the delivery cable (Minnesota wiggle) to ascertain secure device position since the balloon, and not the rim, is used as a support during device deployment.
Slide # 58:
BAT modi cation by Wahab et al. [21]:
This technique utilizes a regular sizing balloon that is positioned across the atrial septal defect to prevent prolapse of the left atrial disk.
Video 46.
ASO embolized to the right ventricle. View supple- mentary video at http://dx.doi.org/10.12945/j.jshd.2016.007.14. vid.46.
Video 47.
ASO being retrieved from the descending thoracic aorta. View supplementary video at http://dx.doi.org/10.12945/j. jshd.2016.007.14.vid.47.
Journal of Structural Heart Disease, February 2016
Volume 2, Issue 1:15-32