Advances in Cardiovascular Imaging Echocardiographic Assessment of Percutaneous Patent Foramen Ovale and Atrial Septal Defect Closure Complications

Atrial septal defect (ASD) is a common congenital defect(1 in 1000 live births) and accounts for up to 40 % of clinically relevant acyanotic shunts in adults.1 Patent foramen ovale (PFO) is much more common and is present in more than 25 % of adults.2,3 The clinical syndromes associated with ASD/PFO represent a significant health burden. Surgical closure is the most common therapy for these defects, and it is associated with low morbidity and mortality. However, it remains a surgical procedure requiring cardiopulmonary by-pass, a significant postoperative recovery, and a sternotomy scar that may be undesirable to young patients. Catheter-based techniques for the treatment of ASD/PFO were pioneered by King and Mills in 1975.4 Since then, significant device development and modifications have been made (Table 1). Percutaneous therapy is now the preferred strategy for ASD/PFO closure, by patients and physician