title: Evaluation of morphological characteristics of septal rims affecting successful transcatheter atrial septal defect closure in children and adults.
abstract: BACKGROUND
  Determining other echocardiographic predictors along with the measured atrial septal defect (ASD) size and evaluating the closure together with these predictors would increase the chance of success for transcatheter closure of ASD.
  
  
  OBJECTIVE
  To evaluate echocardiographic parameters affecting defect closure in children and adult patients with secundum ASD.
  
  
  METHODS
  In all patients, size of ASD, total length of atrial septum (TS), superior-posterior, inferior-posterior, superior-anterior and inferior-anterior rims surrounding the defect were measured by transesophageal echocardiography (TEE), and several measurement ratios were derived on the basis of TEE parameters.
  
  
  RESULTS
  A total 216 patients with secundum ASD were included in this study. The device was successfully implanted in 65 children and 65 adults. Both in pediatric and adult cases, the ratio of successful closure was found to be significantly higher when the ratio of defect size to TS was ≤ 0.35, the ratio of superior-anterior (SA) rim to the defect size was > 0.75 and the ratio of inferior-posterior (IP) rim to the defect size was > 1.0. It was found that having more than one of these predictors in a single case increased the chance of closure success significantly (p < 0.001).
  
  
  CONCLUSIONS
  We concluded that a ratio of the defect size to TS ≤ 0.35, a ratio of SA rim to defect size > 0.75 and a ratio of IP rim to defect size > 1.0 were found to be echocardiographic predictors that could be used in successful transcatheter ASD closure both in children and adults.
authors.affiliation: Department of Pediatric Cardiology, Cumhuriyet University, School of Medicine, Sivas, Turkey.
authors.forename: Mehmet Burhan
authors.initials: MB
authors.lastname: Oflaz
authors.affiliation: Department of Pediatric Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Feyza Aysenur
authors.initials: FA
authors.lastname: Pac
authors.affiliation: Department of Pediatric Cardiology, Mersin Children Hospital, Mersin, Turkey.
authors.forename: Ayse Esin
authors.initials: AE
authors.lastname: Kibar
authors.affiliation: Department of Pediatric Cardiology, Ataturk Hospital, Balikesir, Turkey.
authors.forename: Sevket
authors.initials: S
authors.lastname: Balli
authors.affiliation: Department of Pediatric Cardiology, Yuzuncu Yil University, School of Medicine, Van, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ece
keywords: atrial septal defect; echocardiographic predictors; transcatheter closure