Closure of the interatrial septum: should we do it?

Abstract

Percutaneous closure of a patent foramen ovale (PFO) and atrial septal defect (ASD) is performed frequently. Especially PFO closure has been a subject for discussion but has proven its worth for cryptogenic stroke in patients less than 55 years of age. Closure is also performed for transient ischemic attack (TIA) and sometimes migraine with aura. However, the level of evidence is low for these indications. Many devices have been developed and improved over the years. Some showed to be effective and safe, whereas others are no longer used. Cardiac imaging during these interventional procedures is essential. Transesophageal echocardiography (TEE) is the gold standard at this moment, but the technique keeps on developing to make it less invasive with a reduction in costs. The micro-probe TEE has been described for several percutaneous procedures for structural heart disease, but not for percutaneous ASD-and PFO closure. General introduction and outline of the thesis Chapter 1 13 General introduction and outline of the thesis Chapter 1 17 General introduction and outline of the thesis Chapter 1 19