[Anesthetic management for percutaneous transcatheter closure of atrial septal defect]

Atrial septal defect (ASD) is one of the commonest cardiac anomalies in children. Surgical repair leads to excellent results with very low morbidity and mortality, but percutaneous transcatheter closure with a septal occluder is gradually becoming an alternative method, as it is minimally invasive. Anesthesia with intubation is necessary for this procedure, because transesophageal echocardiography is essential in the evaluation of ASD and placement of the occlusion device for ASD. During the procedure, minor complications including device embolizations and arrhythmia need attention. Balloon test occlusion of atrial septal defects may identify patients with left ventricular restrictive physiology before ASD closure. Intravenous anticongestive conditioning medication might be useful for preventing congestive heart failure after interventional closure of an ASD in the patient with a restrictive left ventricle.