title: Clinical efficiency and safety analysis of transcatheter closure of multiple atrial septal defects in adults.
abstract: BACKGROUND
  Transcatheter closure of atrial septal defects (ASDs) is currently a reliable alternative to surgery, even though challenging in patients with multiple ASDs.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the clinical efficiency and safety of transcatheter closure in multiple ASDs.
  
  
  METHODS
  Multiple ASDs were diagnosed by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The occlusive condition and distance between 2 adjacent ASDs were measured by TTE examination. Then, the number and size of the occluder(s) was determined. TTE examinations were performed after transcatheter closure as follow-up.
  
  
  RESULTS
  The transcatheter procedure was successful in 15 patients with multiple ASDs, using a single occluder in 9 patients and 2 occluders in the remaining 6 patients. Overall, 21 ASD occluders were implanted. During a follow-up period of 6 mo to 5 y, a slight residual shunt was found in 1 patient without any symptoms; a moderate residual shunt was identified at the inferior vena cava and the occluder was removed by surgery 1 mo after procedure. Other complications, including endocarditis, arrhythmia, thromboembolism, and atrioventricular valve damage were not recorded in any of the 15 patients during the follow-up period.
  
  
  CONCLUSIONS
  Transcatheter closure of multiple ASDs is safe and efficient. Two occluders are necessary for the distance of 2 ASDs more than 7 mm, and a single occluder is sufficient for those 7 mm or less.
authors.affiliation: Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China. zysong@public.cta.cq.cn
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: Song
authors.forename: Guo-Xiang
authors.initials: GX
authors.lastname: He
authors.forename: Mao-Qin
authors.initials: MQ
authors.lastname: Shu
authors.forename: Hou-Yuan
authors.initials: HY
authors.lastname: Hu
authors.forename: Shi-Fei
authors.initials: SF
authors.lastname: Tong
authors.forename: Bo-Li
authors.initials: BL
authors.lastname: Ran
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Liu
authors.forename: Yong-Hua
authors.initials: YH
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Jing
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012449:Safety; D016896:Treatment Outcome