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Figure 3 :After attempts at crossing this acquired "luminal" atretic segment of the aorta with a stiff guidewire were unsuccessful, recanalization was possible with a transeptal needle, using biplane cineangiography. Simultaneous injections (a) in the ascending aorta (from an arm approach) and descending aorta were performed and used as a road map (a catheter in the LPA is seen overlying the atretic segment).The transeptal needle was advanced carefully (b) into the ascending aorta from below. A guidewire was then advanced, eventually facilitating stent placement (c)

Figure 3 :After attempts at crossing this acquired