Patient 2. Transthoracic echocardiograms (with and without color-flow Doppler, apical 4-chamber views) show A) left-to-right shunting at the ventricular septal defect preprocedurally (arrow) and B) rapid flow (peak velocity, 4 m/s) through the lower half of the Amplatzer occluder on postoperative day 3 (arrow). C) Serial transthoracic echocardiograms show progressively decreasing shunt flow across the ventricular septum (peak velocities, 4.5 m/s at 1 mo and 3.3 m/s at 2 mo); at 4 months, the flow has disappeared.

LV = left ventricle; RV = right ventricle