Clinical Scorecard: Utilizing Three-Dimensional Transthoracic Echocardiography for Selecting Candidates for Percutaneous Closure of Atrial Septal Defects
At a Glance
Category
Detail
Condition
Atrial Septal Defects
Key Mechanisms
Three-dimensional transthoracic echocardiography provides reliable measurements for defect evaluation and selection for closure procedures.
Target Population
Patients aged 1-44 years referred for atrial septal defect closure.
Care Setting
Pediatric cardiology clinic
Key Highlights
Three-dimensional transthoracic echocardiography is increasingly used for patient selection in percutaneous closure.
It offers a low-risk alternative to sedation-required imaging techniques.
The study evaluated 36 cases over three years, with a median patient age of 6 years.
Direct surgical referral occurred in 42% of cases due to anatomical concerns.
Patients referred for three-dimensional echocardiography often had inconclusive initial imaging.
Guideline-Based Recommendations
Diagnosis
Use three-dimensional transthoracic echocardiography for accurate assessment of atrial septal defects.
Management
Refer appropriate candidates for percutaneous closure based on three-dimensional imaging results.
Monitoring & Follow-up
Monitor patients for complications post-intervention, particularly in those undergoing surgical repair.
Risks
Consider risks associated with large defects and inadequate rims when evaluating for percutaneous closure.
Patient & Prescribing Data
Children and young adults aged 1-44 years with atrial septal defects.
Patients with large defects or inadequate rims are more likely to be referred for surgical closure.
Clinical Best Practices
Utilize a multidisciplinary team approach for evaluating candidates for closure.
Ensure all three-dimensional echocardiograms are performed by a dedicated pediatric cardiology specialist.
Discuss cases in a cardiac conference to determine the best closure strategy.
Related Resources & Content
2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | Circulation
SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions - PMC
Routine application of three-dimensional transesophageal echocardiography-based device selection for transcatheter closure of atrial septal defect without balloon sizing | European Heart Journal - Cardiovascular Imaging | Oxford Academic
Pediatric Cardiology — A New Modification of Temporary Suture-Holding Technique for Transcatheter Repair of Sinus Venosus Atrial Septal Defect
Surgical Endoscopy — Endoscopic Closure of Atrial Septal Defects in Functioning Beating Hearts
Int. Journal of Computer Assisted Radiology and Surgery — Development and feasibility testing of a dynamic image-derived simulation framework for assessing left atrioventricular valve repair strategies
Frontiers in Cardiovascular Medicine — Assessment of the Viability and Initial Results of Transcatheter Closure for Moderate-to-Large Perimembranous Ventricular Septal Defects in Pediatric Patients Using Bioabsorbable Occluders: A Prospective Case Study
2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines | Circulation
SCAI Position Statement on Intracardiac Echocardiography to Guide Structural Heart Disease Interventions - PMC
Routine application of three-dimensional transesophageal echocardiography-based device selection for transcatheter closure of atrial septal defect without balloon sizing | European Heart Journal - Cardiovascular Imaging | Oxford Academic
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