fig4

Figure 4. Transcatheter aortic valve implantation concomitant with patent foramen ovale closure in a 70-year-old female patient with severe symptomatic aortic stenosis (the first 2 images) and patent foramen ovale with atrial septal aneurysm. The patient had a previous history of stroke and Heyde syndrome (induced Von Willebrand disease, lower gastrointestinal bleeding, and anemia). A transfemoral 26-mm balloon-expandable Edwards SAPIEN 3 valve was implanted, followed by patent foramen ovale closure using a 30-mm patent foramen ovale occluder