Figure 1.

Patient 1 periprocedural fusion of fluoroscopy and real-time 3D TEE. A – Preprocedural (top) and postprocedural (bottom) 3D TEE images of the mitral prosthesis. The arrows point to the orifice of the paravalvular leak (PVL) located at 2 o’clock (surgical view) and the occluder position after the deployment. B – Four fused fluoroscopy and real-time TEE images. The X-plain color Doppler images of PVL regurgitant flow (top) are oriented according to C-arm position (left bottom) and are fused with the fluoroscopy image (bottom). The location of PVL is marked by a red circle. C – Guidewire passage through the paravalvular defect. The fluoroscopy image (on the bottom) demonstrates wire crossing the red circle; 3D TEE image (top) confirms the guidewire passage through the defect. The arrow in the 3D TEE image shows the guidewire crossing the defect

Ao – position of the aorta.