Closure of a wide-spaced multi-hole secundum atrial septal defect (MHASD) using a single occluder is difficult to accomplish. Multiple occluder implantation has risks such as incomplete endothelialisation, device embolisation, and residual shunt. Blade or balloon septotomy enables single device occlusion; however, the aforementioned may cause a short circumferential rim with subsequent device instability. This paper describes an inter-defect septal puncture technique for single device closure of different layouts of wide-spaced MHASDs via per-atrial or percutaneous approach under exclusive transoesophageal echocardiographic guidance. This technique combined with anti-tenting puncture equally befits a small caval atrial septal defect and MHASD with a floppy aneurysmal septum.
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| http://dx.doi.org/10.1016/j.hlc.2022.02.009 | DOI Listing |
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