Figure 4: Word of caution regarding the use of goose-neck snare to mark the position of pulmonary valve. Figure shows simultaneous PA (Panel A) and Lateral (Panel B) views angiograms of RVOT. The goose neck snare catheter was positioned at the pulmonary valve via the arterial catheter passed through the PDA. While the position of the snare loop appears appropriate in PA view, it is off-the-mark in the lateral view. In this case, the snare loop is nestled between the bulging valve leaflets and the wall of the sinuses. This image underscores additional safety from biplane imaging and the need for confirmation of pulmonary valve location by more than one method prior to perforation.