Objectives: Conventionally, transcatheter device closure of atrial septal defects (ASD) are performed under the guidance of either transoesophageal echocardiography (TEE, which requires general anaesthesia) or intracardiac echocardiographic (which is costly) in the cardiac catheterization laboratory. We aimed to assess the safety and efficacy of using transthoracic echocardiography to guide this procedure.
Methods: 18 patients (median age 32.5 ± 1.7 years) with haemodynamic significant and suitable ASD underwent transcatheter ASD closure using Amplatzer Septal Occluder. Appropriate device size was selected prior to the procedure based on TEE assessment performed earlier at outpatient echocardiography laboratory. Implantation of the device was guided solely by fluoroscopy and transthoracic echocardiography in the cardiac catheterization laboratory.
Results: The median ASD diameter of the cohort was 20 mm (range 11 to 26 mm) and the corresponding size of devices implanted ranged from 16 to 36 mm (median 28 mm). Procedure was successful in 17 patients without any complication. Only in 1 case, the device could not be deployed in proper position and was retrieved. The median procedural and fluoroscopy times required were short at 28.0 ± 11.7 mins and 4.8 ± 2.8 mins respectively. At 6 months follow up, complete closure and regression of right heart dilatation were documented in all the 17 cases.
Conclusions: Transcatheter closure of ASD under transthoracic echocardiography guidance is safe, fast and feasible.