title: Percutaneous closure of atrial septal defects. The role of transesophageal echocardiography.
abstract: OBJECTIVE
  Evaluation of the role of transesophageal echocardiography in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder.
  
  
  METHODS
  Patients were selected for percutaneous closure of ASD by transesophageal echocardiography (TEE), which was also used to monitor the procedure, helping to select the appropriate size of the Amplatzer device, to verify its position, and to access the immediate results of the procedure. During the follow-up, TEE was used to evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiac chamber diameters.
  
  
  RESULTS
  Twenty-two (40%) of a total of 55 studied patients were selected. Thirteen underwent Amplatzer device implantation, eight are still waiting for it, and one preferred the conventional surgical treatment. All procedures were successful, which was mainly due to proper patient selection. Six (23%) patients acutely developed RS, which spontaneously disappeared at the three-month follow-up examination in three patients. There was a significant reduction in the right ventricle diastolic diameter, from 27 mm (average) to 24 mm and 20 mm, one and three months after the procedure, respectively (p < 0.0076).
  
  
  CONCLUSIONS
  With the aid of TEE, percutaneous closure of ASD can be successfully, safely, and effectively performed.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil.
authors.forename: S R
authors.initials: SR
authors.lastname: Pedra
authors.forename: C A
authors.initials: CA
authors.lastname: Pedra
authors.forename: J E
authors.initials: JE
authors.lastname: Assef
authors.forename: R de S
authors.initials: Rde S
authors.lastname: Cassar
authors.forename: C A
authors.initials: CA
authors.lastname: Esteves
authors.forename: S N
authors.initials: SN
authors.lastname: Braga
authors.forename: S
authors.initials: S
authors.lastname: Pontes Júnior
authors.forename: V F
authors.initials: VF
authors.lastname: Fontes
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D019736:Prostheses and Implants