Nno

Fig. 5. Delivery system for an asymmetric device. (A) Photograph of the slot in the delivery catheter, flat at the upper margin; this matches a flattened area at the upper surface of the microscrew. The microscrew will only fit into the slot in the correct orientation. (B) The asymmetric Perimembranous Ventricular Septal Occluder is attached to the curved delivery catheter. The longer rim of the left ventricular disk is oriented along the lesser curvature of the delivery catheter.

Fig. 6. Angled ductal occluder device without fabric. (A) Photograph of the device showing the external frame, which is composed of 144 wires. Arrows indicate a wire insert shaped like the external frame. (B) Aortogram performed immediately after device placement in a surgically created "ductus arteriosus" in a canine model. The angled aortic disk lies snuggly along the aortic wall. There is immediate complete occlusion of the ductus.

Fig. 6. Angled ductal occluder device without fabric. (A) Photograph of the device showing the external frame, which is composed of 144 wires. Arrows indicate a wire insert shaped like the external frame. (B) Aortogram performed immediately after device placement in a surgically created "ductus arteriosus" in a canine model. The angled aortic disk lies snuggly along the aortic wall. There is immediate complete occlusion of the ductus.

This caused a return to the cardiac catheterization laboratory for interventional procedures.

The Amplatzer family of devices has further changed the face of treatment of congenital heart disease in children. Yet, trans-catheter therapy is not limited to simpler lesions that often precede surgical repair, decreasing the complexity of surgical intervention. Amplatzer devices can also be delivered in the operating room directly through the surface of the heart without cardio-pulmonary bypass. This has brought a new era of cooperation between pediatric cardiologists and cardiovascular surgeons.

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