title: Transcatheter closure of complex atrial septal defects is efficient under intracardiac echocardiographic guidance.
abstract: BACKGROUND
  Studies on intracardiac echocardiography for transcatheter closure of secundum atrial septal defect (ASD) only include ASDs ≤38mm diameter without rim deficiency.
  
  
  OBJECTIVE
  To assess transcatheter closure of complex ASDs under intracardiac echocardiography guidance.
  
  
  METHODS
  Retrospective study from January 2006 to January 2012 in all consecutive adult patients referred to our centre for percutaneous device closure of ASD. Complex cases were defined as defect>38mm and/or defect with rim deficiency other than the anterior-superior rim.
  
  
  RESULTS
  Transcatheter closure was performed in 93 consecutive adult patients (59 women) with a median age of 48 (18-88) years. Complex cases comprised 17 patients (18%) with a median age of 54 (20-81) years and a median weight of 58 (45-99) kg. Thirteen cases had one or more deficient rims other than the anterior-superior rim, whereas nine had an ASD size>38mm. Transcatheter closure was successful in 14 cases, whereas three cases failed (18%). Minor complications occurred in three patients (18%). All the other non-complex ASDs were successfully closed percutaneously. Among the 93 patients, rim deficiency other than the anterior-superior rim tended to be associated with failure of transcatheter closure (P=0.058).
  
  
  CONCLUSIONS
  Transcatheter closure of complex ASDs is safe and effective under intracardiac echocardiographic guidance.
authors.affiliation: Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: Anass
authors.initials: A
authors.lastname: Assaidi
authors.affiliation: Service de cardiologie B, hôpital de la Timone-Adultes, Marseille, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Sumian
authors.affiliation: Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: Lucia
authors.initials: L
authors.lastname: Mauri
authors.affiliation: Biostatistiques et technologies de l'information et de la communication (BiosTIC), hôpital de la Timone, Aix Marseille Université, Inserm, IRD, UMR_S912, SESSTIM, Marseille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.affiliation: Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Ovaert
authors.affiliation: Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: Erwann
authors.initials: E
authors.lastname: Salaun
authors.affiliation: Service de cardiologie B, hôpital de la Timone-Adultes, Marseille, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Cardiologie pédiatrique et congénitale, hôpital de la Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: alain.fraisse@ap-hm.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Fraisse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055989:Septal Occluder Device; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000009:adverse effects; D055815:Young Adult
keywords: ASD/PDA/PFO closure; Adult congenital heart disease; CIA/canal artériel/FOP fermeture; Cardiopathie congénitale de l’adulte; Imagerie par échocardiographie intracardiaque; Intracardiac echocardiography imaging