Abstract：Objective: This study reports our clinical experience of interventional treatment of multi-fenestrated atrial septal defect(ASD) under echocardiography. Methods: From December 1998 to March 2005, 11 patients, 2 males, 9 females, with mean age of 26.1±4.2 years(ranged from 4 to 60 years old), underwent percutaneous closure of multi-fenestrated ASD. Out of the 11 patients, 8 had two defects, 2 had three defects, 1 had four defects. Two of the 11 patients associated with atrial septal aneurysm, one with atrial fibrillation and hydropericardium. The frequency of detecting probe used was 2.5MHz and 5.0MHz respectively. Diagnosis was determined with transthoracic or transesophageal echocardiography before procedure, procedure was performed under support of transesophageal echocardiography. Transthoracic echocardiography(TTE) was used on the second day after the procedure and during follow-up. TTE mainly observed in parasternal, cardiac apical, inferior xiphoid process four chamber view, and inferior xiphoid process couple atrium, great artery minor axial views, and TEE mainly reviewed in atrial septal long axis, superior vena cava long axis, inferior vena cava, great artery minor axis, four chamber view. Results: Nine of the 11 patients were successfully treated with single occluder(device size ranged from 12 to 40mm), two were implanted with two devices for effective closure of all defects(occluder diameter 18 and 8mm). During follow-up, residual shunting was observed in two of the 11 patients, and no other complications were noted. Conclusions: Multi-fenestrated ASDs should be closed under transesophageal echocardiographic guidance to determine number, diameter and distance of ASDs. We should try our best to close multi-fenestrated ASDs with one device.
2006, Vol. 17 
