604 PERCUTANEOUS TRANSCATHETER CLOSURE OF SYMPTOMATIC PATENT FORAMEN OVALE IN PATIENT WITH INFERIOR VENA CAVA INTERRUPTION

Abstract Percutaneous closure of a patent forame ovale (PFO) is indicated in selected patients with confirmed cryptogenic stroke, transient ischemic attack (TIA), or systemic embolism and an estimated high probability casual role the PFO as assessed by clinical, anatomical imaging features. This procedure usually undertaken from femoral vein. In this case, patient was affected vena cava agenesis compensatory enlargement azygos We performed percutaneous using 9F jugular vein access. advanced straight guide trough foramen Multipurpose 6F catheter supported Destino Oscor 8F. Then we changed Amplatz Super-Stiff 0.035" left ventricle, on which Mullins trans-septal advanced. Finally delivered Amplatzer Multifenestrated Septal Occluder "Cribriform" 25/25 mm. our it impossible to perform classic access due inferior agenesis. Performing right internal venous approach technically challenging but safe possible standard equipment normally present Catheterization Laboratory. rare cases indication for lack through veins, alternative techniques shelf materials help overcoming anatomies. The use steerable critical engaging unfavourable angulation. nitinol double disk devices effective.