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Heart, Lung and Circulation

Inter-Defect Septal Puncture Technique For Single Device Closure of Wide-Spaced Multi-Hole Atrial Septal Defect

  • Author Footnotes
    # Co-first authors contributed equally.
    Yue-Kun Sun
    Footnotes
    # Co-first authors contributed equally.
    Affiliations
    Department of Cardiovascular Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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  • Author Footnotes
    # Co-first authors contributed equally.
    Shi-Bin Sun
    Footnotes
    # Co-first authors contributed equally.
    Affiliations
    Department of Cardiovascular Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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  • Li Hongxin
    Correspondence
    Corresponding author at: Department of Cardiovascular Surgery, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
    Affiliations
    Department of Cardiovascular Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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  • Geoffrey Joseph Changwe
    Affiliations
    Department of Cardiovascular Surgery, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
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  • Author Footnotes
    # Co-first authors contributed equally.
Published:March 24, 2022DOI:https://doi.org/10.1016/j.hlc.2022.02.009
      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.

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