The Problem of Transcatheter Closure of Multiple Atrial Septal Defects: Interventional Approaches and Results. Literature Review

Highlights The article presents a review of the literature and the results of endovascular correction of multiple atrial septal defects, methods of occluder implantation. Indications for transcatheter closure and possible complications of the procedure are given. Abstract Over the past few decades, the treatment strategy for the second atrial septal defect has changed significantly. Due to the improvement of device technology and procedural techniques, transcatheter closure of atrial septal defects is currently considered to be the method of choice in most patients with secondary types of defects. The latest generation devices provide a simple and safe implantation. The use of biocompatible occluder materials contributes to endothelization and reduction of traumatization of nearby structures. Most of the currently available devices demonstrate excellent efficiency and comparable results with their own advantages and disadvantages. In addition to improving the properties and performance of the device, there was a clear improvement in the procedural technique because of numerous experiments with closing of the device. A difficult problem for an endovascular surgeon is the procedure for closing multiple defects, due to their shapes, locations on the septum, the lack of a sufficient amount of tissue edge on the septum, as well as difficulties with choosing the type of device, their number and relative location.