ABSTRACT
Atrial septal defect closure is discussed in a separate chapter, and therefore this discussion will focus on patent foramen ovale (PFO) closure. After the first 25 patients, two patients underwent closure with both Transesophageal echocardiography and guidance by intracardiac echocardiography (ICE) and then all but one of our subsequent patients underwent closure with ICE alone. In some patients, a transseptal approach as described by Ruiz et al., may allow for improved seating of the CardioSEAL device and better initial closure as assessed by contrast echocardiography. The ICE technique for transseptal catheterization is quite similar to the previously described technique for PFO closure. Although a retrograde approach to balloon valvuloplasty from the ventricular side has been described, the overwhelming majority of current procedures worldwide utilize an antegrade transseptal approach with either the single Inoue or double polyethylene balloon technique. The techniques for device implantation vary with hospital and operator.
