Transcatheter closure of intracardiac defects in adults

There has been a dramatic increase in the adult congenital heart disease population and appreciation of intracardiac shunt lesions discovered or acquired in adults over the past several years. Fortunately, this increase has been met with advances in imaging modalities, which permit a more accurate noninvasive assessment of cardiac defects. Additionally, the evolutions in both device technology as well as fluoroscopic and echocardiographic image guidance have permitted the safe and effective catheter-based closure of numerous intracardiac defects. With catheter-based closure procedures now considered the treatment of choice in most cases of intracardiac defect repair in adults, it is imperative that clinicians possess a sound understanding of intracardiac shunt lesions and indications for repair or closure so that they may better care for this unique subset of adult patients. This review will focus on the anatomy, pathophysiology, and current transcatheter therapeutic options for adult patients with patent foramen ovale (PFO), atrial septal defects (ASD), and ventricular septal defects (VSD).