Utility of on-line three-dimensional transesophageal echocardiography during percutaneous atrial septal defect closure.

Key echocardiographic assessments during percutaneous atrial septal defect (ASD) closure are the maximal defect diameter, the presence or absence of tissue rims, and the spatial relationships between the implanted device and cardiac structures. These assessments drive device selection and may help identify situations that may place a patient at risk for device erosion or other complications. On-line three-dimensional (3D) transesophageal echocardiography (TEE) enables the rendering of nearly unlimited tissue planes within an acquired pyramidal-shaped volume with minimal image post-processing. We present several cases of percutaneous ASD closure guided by on-line 3D TEE imaging that highlight the potential advantages of this new imaging technology.