Percutaneous closure of atrial fistula after ascending aortic aneurysm surgery using cardiac fusion imaging

Figure 1. Cardiac fusion imaging for procedural guidance. A) 2D TEE Doppler colour image showing the aorto-right atrial shunt (white arrow). B) CTA-fluoro fusion image: cardiac fusion imaging guidance to cross the fistula from the aorta (AO) to the right atrium (RA). C) Fluoro image: stiff wire crossing from the aorta into the right atrium. D) CTA-fluoro fusion image: wire advanced and snared into the inferior vena cava (IVC). E) CTA-fluoro fusion image: device deployment guided by cardiac fusion imaging. F) Fluoro image: final result showing the AMPLATZER Duct Occluder (ADO) device (red arrow) sealing the aorto-atrial fistula.

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