Abstract
Transcatheter closure of secundum-type atrial septal defect (ASD) is now an acceptable alternative to open heart surgery [1, 2, 5, 8]. It is possible in selected patients to close ASDs using imaging assistance with transthoracic, transesophageal, or intracardiac echocardiography. While interventional ASD closure of small to moderatesized ASDs is technically easy and standardized [4], closure of large ASDs associated with a deficient rim at the aortic root and a small left atrium may be technically challenging regarding prevention of a prolapse of the left atrial disc into the right atrium during deployment. Several attempts have been made to overcome these technical limitations, either by modifications of deployment techniques, e.g., right upper or left upper pulmonary vein technique [6], by use of special sheaths, e.g., a Hausdorf sheath [7], or by dilator-assisted device deployment [6, 10]. We report our preliminary experience with mechanical support of the left atrial disc during device deployment in children.
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