Ann Card Anaesth Close
 

Figure 2: (a-g) Live/real time three-dimensional transeso phageal echocardiographic assessment of device embolization during percutaneous atrial septal defect (ASD) closure. (a) The arrowheads point to multiple secundum ASD (ASD, "swiss cheese" appearance) viewed en face from the left atrium (LA). (b) Color Doppler assessment showing flow signals within the defects viewed en face (left panel). QLAB examination (right panel) showing four defects numbered 1, 2, 3, and 4. (c) QLAB examination demonstrating en face view of one of the defects (1) using color Doppler. In the upper left panel the cropping plane is positioned exactly parallel to the defect which resulted in en face viewing of the defect in the lower left panel. Subsequently the area was measured by planimetry. (d) Demonstrates the first ASD closure device (D1) in position (viewed from left atrium and anatomically correct). Arrowhead shows a large residual defect viewed en face. The arrow points to the device placement catheter. (e) The second ASD closure device (D2) in position, partially overlapping D1 (viewed from left atrium and anatomically correct). Arrowhead shows the presence of one of the two significant residual defects. (f) Embolization of one of the closure devices (d) to the LA. (g) The device (d) in the proximal descending thoracic aorta (DA) after percutaneous manipulation from the iliac artery. 1 and 2 denote the right and the left atrial sides of the device, which are viewed en face in the left lower and the right upper panels (MV: Mitral valve; RA: Right atrium). Reproduced with permission from Wei J, Hsiung MC, Tsai SK, et al. Atrial septal occluder device embolization to an iliac artery: A case highlighting the utility of three-dimensional transesophageal echocardiography during percutaneous closure. Echocardiography 2012;29:1128-31

Figure 2: (a-g) Live/real time three-dimensional transeso phageal echocardiographic assessment of device embolization during percutaneous atrial septal defect (ASD) closure. (a) The arrowheads point to multiple secundum ASD (ASD,