Table III.
Technical description of individual implantation steps
| PVL location/prosthesis mechanical (m) or biological (b) | Delivery sheath | PLD size | PLD implanted into PVL channel/optimal rotation gained | Release from delivery cable | Device success |
|---|---|---|---|---|---|
| Aortic/m | 8 Fra > 7 Frb,h | 10 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 9 Fre | 8 × 4 | Y/Nk | Uneventful | N (significant residual flow) |
| Mitral/m | 12 Frf | 12 × 5 | Y/Y | Uneventful | Y (mild residual leak) |
| Aortic/b | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/m | 6 Frc > 6 Frc,i | 6 × 3 | Y/Y | Repeated maneuvers necessary | Y (mild residual leak) |
| Aortic/m | 6 Frc | 6 × 3 | Y/Nl | Uneventful | Y (complete closure) |
| Aortic/b | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/b | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/m | 6 Frc | 6 × 3 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/m | 6 Frc | 6 × 3 | Y/Nl | Uneventful | Y (complete closure) |
| Aortic/m | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 12 Frg | 12 × 5 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 9 Fre > 12 Frg,j | 10 × 4 | Y/Y | Uneventful | Y (mild residual leak) |
| Mitral/b | 8 Frg | 6 × 3 | Y/Y | Uneventful | Y (mild residual leak) |
| Mitral/b | 12 Frf | 12 × 5 | Y/Y | Uneventful | N (significant residual flow) |
| Mitral/m | 9 Fre | 8 × 4 | Y/Nl | Uneventful | Y (complete closure) |
| Aortic/b | 6 Frc | 4 × 2 | Y/Y | Repeated maneuvers necessary | Y (complete closure) |
| Mitral/m | 12 Frg | 12 × 5 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 12 Frf | 12 × 5 | Y/Y | Uneventful | Y (mild residual leak) |
| Aortic/b | 6 Frc | 4 × 2 | Y/Nl | Uneventful | Y (complete closure) |
| Aortic/m | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 9 Fre | 12 × 5 | Y/Y | Uneventful | Y (mild residual leak) |
| Mitral/m | 6 Frc | 6 × 3 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/b | 6 Frc | 6 × 3 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/b | 6 Frc | 6 × 3 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/b | 6 Frc | 4 × 2 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/m | 6 Frc | 6 × 3 | Y/Nl | Uneventful | Y (complete closure) |
| Mitral/m | 7 Frb | 8 × 4 | Y/Y | Uneventful | Y (mild residual leak) |
| Aortic/b | 8 Fra,d | 12 × 5 | Y/Y | Repeated maneuvers necessary | Y (complete closure) |
| Mitral/m | 9 Fre | 8 × 4 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 6 Frc | 4 × 2 | Y/Y | Uneventful | Y (complete closure) |
| Aortic/m | 6 Frc | 6 × 3 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/b | 12 Frf | 12 × 5 | Y/Y | Uneventful | Y (complete closure) |
| Mitral/m | 12 Frf | 12 × 5 | N/Y | n/a | N (occluder unstable, removed) |
| Mitral/m | 13 Frf | 18 × 10 | Y/Y | Uneventful | Y (mild residual leak) |
Flexor Shuttle Guiding Sheath (COOK Medical) 90 cm
Flexor Shuttle Guiding Sheath (COOK Medical) 110 cm
Flexor Shuttle Guiding Sheath (COOK Medical) 110 cm
9 Fr Amplatzer TorqVue too short for aortic location accessed from femoral puncture; undersized 8 Fr sheath 10 cm longer used
Amplatzer TorqVue (St Jude Medical) 80 cm 45°
Amplatzer TorqVue (St Jude Medical) 80 cm 45° oversized to encompass additional 0.035” control wire
telescopic system used for transapical approach, consisting of a longer (23 cm) delivery sheath also used as a PLD loader and wider by 2 Fr, shorter (15 cm) sheath serving as a transapical access; both sheaths normally used for peripheral access
8 Fr Flexor Shuttle Guiding Sheath too short – exchanged for an undersized 7 Fr longer (110 cm) sheath
Delivery sheath damaged by the occluder while passing the transversely located PVL channel; exchanged for a new one, the same type
delivery sheath damaged (kinked) in the left atrium; exchanged for a wider one, allowing simultaneous use of a stiff control wire, maintaining proper shape of the sheath inside the LA
rotation difficult due to severely angulated delivery sheath
rotation difficult due to the proximity of surrounding structures.