Closure of a wide-spaced multi-hole secundum atrial septal defect (MHASD) using a
single occluder is difficult to accomplish. Multiple occluder implantation has risks
such as incomplete endothelialisation, device embolisation, and residual shunt. Blade
or balloon septotomy enables single device occlusion; however, the aforementioned
may cause a short circumferential rim with subsequent device instability. This paper
describes an inter-defect septal puncture technique for single device closure of different
layouts of wide-spaced MHASDs via per-atrial or percutaneous approach under exclusive
transoesophageal echocardiographic guidance. This technique combined with anti-tenting
puncture equally befits a small caval atrial septal defect and MHASD with a floppy
aneurysmal septum.
Keywords
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References
- Blade consolidation of multiple atrial septal defects: A novel approach to transcatheter closure.Pediatr Cardiol. 2004; 25: 671-674
- Device closure of fenestrated atrial septal defects: Use of a single Amplatz atrial septal occluder after balloon atrial septostomy to create a single defect.Catheter Cardiovasc Interv. 2001; 52: 203-207
- Intra-operative device closure of multiple atrial septal defects facilitated by a unique atrial septum remodeling technique: Initial results and experience in 11 patients.Eur J Cardiothorac Surg. 2012; 4: 266-271
Article info
Publication history
Published online: March 24, 2022
Accepted:
February 11,
2022
Received in revised form:
January 29,
2022
Received:
January 4,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
