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. 2021 Apr 21;2021:6659261. doi: 10.1155/2021/6659261

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Copyright © 2021 Zhenyi Ge et al.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Transapical puncture and introducing the valve-crossing device. (a) X-plane view shows the guidewire enters LA through the mitral orifice (orange arrowhead). After that, a 6F guidewire is exchanged and advanced into LV and LA on a similar view. (b) Arrowhead. (c) 3D enface view + X-plane view show the introducer sheath is inserted coaxially to the LV and the insertion depth is approximately 3 cm (orange line). (d) The valve-crossing device is loaded into the introducer sheath and can be shifted in full directions (green arrows) within a reasonable scope of the MV orifice. (e) Coaxial advancement of the introducer sheath into the center of LA along the rod of valve-crossing device. AP: apex.