Related Experiment Video
Updated: Apr 23, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter closure of complex atrial septal defects is efficient under intracardiac echocardiographic guidance
Anass Assaidi1, Marion Sumian2, Lucia Mauri1
1Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
Insights
Intracardiac echocardiography enables safe and effective transcatheter closure for complex atrial septal defects (ASDs), including larger or rim-deficient cases. This approach expands treatment options for patients with challenging ASD anatomy.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Imaging
Background:
- Previous studies on intracardiac echocardiography (ICE)-guided transcatheter closure of secundum atrial septal defects (ASDs) were limited to defects ≤38mm without rim deficiency.
- Complex ASDs, defined as defects >38mm or with rim deficiency, presented a challenge for existing closure techniques.
Purpose of the Study:
- To evaluate the safety and efficacy of transcatheter closure for complex atrial septal defects (ASDs) using intracardiac echocardiography (ICE) guidance.
- To assess the feasibility of percutaneous device closure in adult patients with challenging ASD anatomies.
Main Methods:
- A retrospective analysis of 93 consecutive adult patients undergoing percutaneous device closure of ASD between January 2006 and January 2012.
- Complex cases were identified as those with ASD diameter >38mm and/or rim deficiency (excluding the anterior-superior rim).
- Intracardiac echocardiography was utilized for guidance throughout the transcatheter closure procedure.
Main Results:
- Transcatheter closure was performed in 93 adult patients; 17 (18%) had complex ASDs (larger size or rim deficiency).
- Successful closure was achieved in 14 of 17 complex cases (82%), with 3 failures (18%). Minor complications occurred in 3 patients (18%).
- Rim deficiency, excluding the anterior-superior rim, showed a trend towards association with closure failure (P=0.058).
Conclusions:
- Transcatheter closure of complex atrial septal defects (ASDs) is a safe and effective procedure when guided by intracardiac echocardiography.
- ICE guidance facilitates the percutaneous closure of challenging ASD anatomies, expanding treatment possibilities.
Background:
Studies on intracardiac echocardiography for transcatheter closure of secundum atrial septal defect (ASD) only include ASDs ≤38mm diameter without rim deficiency.
Aims:
To assess transcatheter closure of complex ASDs under intracardiac echocardiography guidance.
Methods:
Retrospective study from January 2006 to January 2012 in all consecutive adult patients referred to our centre for percutaneous device closure of ASD. Complex cases were defined as defect>38mm and/or defect with rim deficiency other than the anterior-superior rim.
Results:
Transcatheter closure was performed in 93 consecutive adult patients (59 women) with a median age of 48 (18-88) years. Complex cases comprised 17 patients (18%) with a median age of 54 (20-81) years and a median weight of 58 (45-99) kg. Thirteen cases had one or more deficient rims other than the anterior-superior rim, whereas nine had an ASD size>38mm. Transcatheter closure was successful in 14 cases, whereas three cases failed (18%). Minor complications occurred in three patients (18%). All the other non-complex ASDs were successfully closed percutaneously. Among the 93 patients, rim deficiency other than the anterior-superior rim tended to be associated with failure of transcatheter closure (P=0.058).
Conclusion:
Transcatheter closure of complex ASDs is safe and effective under intracardiac echocardiographic guidance.
More Related Videos
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:24Cardiac Catheterization III: Left Heart Catheterization