Device closure of fistula from left lower pulmonary artery to left atrium using a vascular plug: A case report

Figure 2 Lateral pulmonary angiography and the course of the guidewire. A: Lateral pulmonary artery angiography using a 6-Fr pigtail catheter showing a large left pulmonary artery-to-left atrial fistula associated with a large aneurysmal sac; B: A Terumo wire (0.35 cm × 260 cm) and 5-Fr multipurpose catheter helped to negotiate the highly tortuous course of the fistula to reach beyond the targeted landing zone and the site of guide wire placement in the upper right pulmonary vein via the aneurysmal sac for adequate support. Red arrow: 8-Fr sheath; yellow arrow: 5-Fr multipurpose catheter through the delivery sheath; blue arrow: guidewire in the aneurysmal sac; green arrow: upper right pulmonary vein.