Closure of a two-hole secundum atrial septal defect through a transthoracic atrial septal defect occlusion device

A simple method to close a 2-hole secundum atrial septal defect (ASD) is described. The right atrium was approached through a minithoracotomy. A double-ring purse string suture was made for the introducer shaft of the ASD occlusion device, and another purse string was made for a slim tissue scissors. A slim tissue scissors was introduced to the right atrium, and the bridge of tissue between the 2 holes was cut. The maximum diameter of the neo-ASD was measured. Thus, the ASD occlusion device of appropriate size could be selected and be placed in position.