This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Arcidiacono, C. Articles by Carminati, M. Search for Related Content PubMed PubMed Citation Articles by Arcidiacono, C. Articles by Carminati, M. Related Collections Echocardiography

Cardiovascular Images

Percutaneous Closure of Multiple Secundum Atrial Septal Defects Using 3 Amplatzer Atrial Septal Occluder Devices

Evaluation by Live Transthoracic 3-Dimensional Echocardiography

Carmelo Arcidiacono, MD; Gianpiero Gaio, MD; Gianfranco Butera, MD and Mario Carminati, MD

From the Department of Pediatric Cardiology (C.A., G.B., M.C.), Istituto Policlinico San Donato IRCCS, San Donato Milanese, Italy; and the Department of Pediatric Cardiology (G.G.), Seconda Università degli Studi, Azienda Ospedaliera Monaldi, Napoli, Italy.

Correspondence to Carmelo Arcidiacono, MD, Department of Pediatric Cardiology, Istituto Policlinico San Donato IRCCS, Via Morandi 30, 20097 San Donato Milanese, Italy. E-mail c_arcidiacono@hotmail.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A previously healthy 12-year-old boy was admitted to the hospital with acute pneumonitis. On admission, a heart murmur was detected. The transthoracic echocardiogram showed multiple secundum atrial septal defects with left-to-right shunt and signs of right ventricular volume overload. He underwent right cardiac catheterization and transesophageal echocardiogram (transesophageal echocardiography): 3 sizeable atrial septal defects (anterosuperior, measuring 10 mm; posterior, 9 mm; anteroinferior, 6 mm) were closed with 3 Amplatzer atrial septal occluder devices, measuring 10, 9, and 6 mm (Figures 1 and 2). A good result was achieved, with no residual shunt across the atrial septum and no complications. The live transthoracic 3D (Figures 3 and 4, Data Supplement Movies I and II) and concurrent transesophageal echocardiography assessment at the end of the procedure showed good position of the devices, no residual interatrial shunts, no interference with the atrioventricular valves, and no obstruction to the venous returns.

View larger version (135K):   Figure 1. Angiographic image of the 3 Amplatzer atrial septal occluder devices after release, indicated by the black arrows.

 

View larger version (125K):   Figure 2. Angiographic image of the 3 Amplatzer atrial septal occluder devices after release, indicated by the black arrows. In the bottom right corner, the delivery sheath is visible.

 

View larger version (28K):   Figure 3. Live transthoracic 3D image of the right surface of the atrial septum with the 3 devices indicated by white and black arrows.

 

View larger version (29K):   Figure 4. Live transthoracic 3D image of the right surface of the atrial septum with the 3 devices indicated by white and black arrows.

 
To our knowledge, . . . [Full Text of this Article]