Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect

Objective To explore the value of transthoracic echocardiography(TTE)in transcatheter closure of atrial septal aneurysm(ASA)combined with secoundum-type atrial septal defect(ASD).Methods Fourteen patients(3 males and 11 females)who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography.The ASA projected to the right atrium in all patients.The width of basilar part was 13~24(18.5±3.9)mm,and the vertical extent was 7~11(9.7±1.8)mm.Ten patients combined with single hole ASD and 4 patients with multiple hole ASD.Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients.All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE,and examined with TTE during the follow-up.Results Transcatheter closure was successfully performed by 14 occluders in all patients.No residual shunt was detected immediately by TTE after the procedure in all patients.During the 6~12 month follow-up,no residual shunt or occluder shifting was found,the dimensions of the heart became normal in 11 patients(79%)and were signifantly decreased in 4.Conclusion Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD,and extra attention must be paid to the speciality.TTE is very important in case selection before transcatheter closure,and it may be used to monitor and guide the procedure during transcatheter closure.