title: Intracardiac echocardiography to guide percutaneous closure of atrial baffle defects.
abstract: BACKGROUND
  Patients with complex congenital heart disease may require surgical construction of interatrial baffles to shunt blood between atria. Long-term complications of these procedures may include stenosis or leak of the baffle, typically along the suture line. There are limited data on transcatheter management and intraprocedural imaging of these anatomically complex lesions.
  
  
  METHODS
  We describe three cases of adults who each presented with baffle leaks more than 20 years after surgical construction of an atrial baffle. In each case, intracardiac echocardiography was essential for intraprocedural guidance, sizing of the defect, and successful percutaneous deployment of an Amplatzer septal occluder device to close the baffle leak.
  
  
  CONCLUSIONS
  One patient had a baffle leak along the inferior surface of the baffle suture line; the second patient had a baffle leak along the superior border with the left atrium; the third patient had a leak along the sutures of surgical shunt for an anomalous pulmonary vein. Percutaneous closure was successful in all cases, with deployment of an Amplatzer occluder device in each case. Intracardiac echocardiography may be may be useful for procedural guidance during percutaneous closure of atrial baffle defects.
authors.affiliation: Division of Cardiovascular Medicine, University of California, Davis Medical Center Sacramento, CA 95817 USA.
authors.forename: Ehrin J
authors.initials: EJ
authors.lastname: Armstrong
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Kwa
authors.forename: Aarti
authors.initials: A
authors.lastname: Bhat
authors.forename: Benjamin
authors.initials: B
authors.lastname: Romick
authors.forename: Thomas
authors.initials: T
authors.lastname: Smith
authors.forename: Jason H
authors.initials: JH
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D055989:Septal Occluder Device; D018084:Ultrasonography, Interventional