Pictorial depiction of the transhepatic access demonstrating a left-sided liver and IVC, a longer right common iliac vein, and the guidewire access to the IVC via the hepatic vein.

Pictorial depiction of the transhepatic access demonstrating a left-sided liver and IVC, a longer right common iliac vein, and the guidewire access to the IVC via the hepatic vein.

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Secundum atrial septal defect (ASD) is the most common type of ASD. Symptoms including dyspnea on exertion usually manifest in the third and fourth decade of life. The transcatheter closure is the treatment of choice for secundum ASD. The transfemoral venous approach has been the mainstay. However, this approach can be challenging or impossible in...