Failed to withdraw the device into the sheath despite multiple attempts. The 30 mm device could not be withdrawn into 14 F sheath despite manipulations. What could be the reason? Options?

Cutting (and rotationally optimizing) a bevel on the end of the sheath can help. Video credit to Dr. Michael Slack

Thank you for this information. I haven’t seen any operator trying it in my institution. Any chance for injury by the sharp edges?

Pulmonic valve is causing resistance. Better to advanced retrieving sheath holding the system as a rail rather than pulling device inside sheath by the snare.

I have never done it..but this technique would have solved the issue ...

Generally ASD needs to be held at both ends to be slenderised into a sheath , especially the larger devices. Also the sheath needs to be largest sized with a bevel created ( Hausdorf ) sheath if available.

I have never done so, catching both ends while retrieving ASD devices. We have done retrieval twice in past

Usually will require a larger sheath, such as 20 Fr. or even larger.

Is the LA disk holding onto something?

Pulm valve I think

Coz hook is not aligned with axis of sheath ...need one more snare to do it..

Both types of snares used