Figure 3. Step by step of the percutaneous intervention. A) Angiography in the venous introducer showing the inferior vena cava draining into the heart of the second twin. B, C, D) Fluoroscopy showing the ductus arteriosus crossed with guide and catheter passing through the right atrium, right ventricle, pulmonary trunk in the descending aorta in an anterograde fashion, and aorta and being positioned in the descending aorta. E) Angiography of the ductus arteriosus. F) Fluoroscopy showing the advancement of the sheath from the pulmonary trunk to the descending aorta. G) Piccolo^© device and its radiopaque marks being positioned. The esophageal thermometer is usually a radiopaque landmark to delimit the aortic ampulla, and the orotracheal cannula is usually a radiopaque landmark to delimit the pulmonary ampulla. Ao: aorta; Desc Ao: descending aorta; PT: pulmonary trunk; RA: right atrium; RV: right ventricle.