Figure 1.

Interventional Percutaneous Implantation of the Atrial Flow Regulator-Device in a 13-Year-Old Girl With Restrictive Cardiomyopathy, Heart Failure With Preserved Ejection Fraction, and Mild Pulmonary Hypertension

(A) Atrial transseptal puncture with Brockenbrough needle. (B) Balloon dilation of the atrial septum (Cordis Powerflex, 8 mm × 3 cm). (C) A guide wire has been positioned in the left upper pulmonary vein and a 12-F long delivery sheath is advanced across the atrial septum. (D) Deployment of the left atrial disc of the 8-mm atrial flow regulator (AFR) device. (E) The right atrial disc is deployed, and the AFR device is properly positioned. (F) After a pull maneuver, the AFR device has been released. (G) Transesophageal echocardiogram shows good position of the AFR device and restrictive atrial left-to-right shunt (6 mm).