Anaesthesia for percutaneous closure of atrial septal defects

Interventional cardiology has undergone considerable advances in device technology over the past 20 yr. Anaesthesia or sedation is required for a number of these procedures as pain or general discomfort is frequently a feature coupled with the requirement to lie supine and still for up to 1 h or more. Percutaneous atrial septal occlusion is a well developed and commonly performed intervention. Trans-oesophageal echocardiography (TOE) is required as a part of the procedure, which is most often carried out in the catheter lab under general anaesthesia. Percutaneous closure avoids the need for surgery and sternotomy, and is thus associated with significantly fewer complications and greater patient satisfaction.