Assessment of secundum atrial septal defect before transcatheter closure by transesophageal echocardiography

Objective To establish an standardized scoring system for secundum atrial septal defect(ASD) before percutaneous transcatheter closure and to testify this system. Methods Two hundreds and ten patients with pure secundum ASD were considered for Amplatzer occluder device implantation. Transesophageal echocardiography (TEE) was performed before the intervention therapy and meanwhile the anatomy of ASD was given a score according to its diameter,shape,location in order to appreciate its suitability for interventional therapy. Results Two hundreds and four cases were implanted successfully with Amplatzer device and 6 failed. The maximal diameter of the ASD ranged from 4 to 31 mm[( 19.7 ± 6.3 )mm], with Amplatzer occluder selected of 10 to 36 mm[( 23.8 ± 6.6 )mm] accordingly. ASD score ≤6 was considered as excellent candidate for transcatheter closure, whereas score between 7 to 9 was relatively difficult to close and score from 10 to 12 was absolutely unclosable.Conclusions TEE was an optimal imaging technique to evaluate ASD anatomy, using TEE score system, the proper cases for transcatheter closure can be appreciated.