Atrial Septal Defect: Left Atrial Appendage
摘要
The first part of this chapter presents a step-by-step approach for the transcatheter closure of a septal defect in patients with clinical and anatomic suitability. Pathologies of the atrial septum include a range of different interatrial communications varying from patent foramen ovale to true defects of the interatrial septum within the fossa ovalis, such as secundum atrial septal defects and defects of interatrial septum outside the region of fossa ovalis, such as the ostium primum defect, the sinus venosus, and the unroofed coronary sinus. During recent decades, percutaneous intervention has become a feasible and safe method for interatrial shunts. The second part of this chapter presents a step-by-step approach for the percutaneous closure of left atrial appendage as an alternate method of reducing thromboembolic risk in patients with atrial fibrillation at increased risk for thromboembolic stroke and who cannot safely receive oral anticoagulation. This catheter-based technique provides an atrial endoluminal mechanical orifice obstruction and lately has become a feasible and safe method for patients with an indication.