ECHOCARDIOGRAPHIC PREDICTORS OF CANDIDACY FOR SUCCESSFUL TRANSCATHETER ATRIAL SEPTAL-DEFECT CLOSURE

We reviewed pre closure echocardiograms on all patients undergoing tra nscatheter atrial septal defect (ASD) closure with the Bard double-umb rella occluder device aided by simultaneous transesophageal echocardio graphy to determine precatheterization predictors of outcome, Transeso phageal echocardiograms were performed on 28 of 132 patients (22%) und ergoing device closure (age = 3-72 years, mean = 14 years; weight = 15 -68 kg, mean = 35 kg), Three devices were removed because of unstable position, Of the remaining 25 patients, 21 had effective closure (resi dual flow diameter less than or equal to 3 mm) and 18 had favorable ar m position (device arm on proper side of the septum and not in contact with an atrioventricular valve leaflet). Only ASD size predicted effe ctive closure. All patients with a maximum defect size of < 13 mm had effective closure, Among the 17 patients with defects greater than or equal to 13 mm, 10 had effective closure, 4 had significant residual f low, and 3 had devices removed for unstable position, Atrial dimension s and rim size did not predict effective closure, There were no pre-cl osure predictors of favorable arm position which was associated only w ith the size of the device implanted. (C) 1995 Wiley-Liss, Inc.