Real-time imaging for transcatheter closure of atrial septal defects

Nowadays transcatheter closure has become the standard treatment for an atrial septal defect (ASD). Since morphologic variation of ASD is common, imaging modalities with high diagnostic ability continue to be required. Meanwhile, experts are required to visualize high quality images with advanced imaging modalities. Echocardiography plays a pivotal role in patient selection for treatment, recently introduced 3D echocardiography is a promising modality to provide comprehensible en face images of ASD, especially in patients with a complex-shaped ASD. In addition, cardiac MRI and computed tomography can provide complementary information. Transesophageal echocardiography and intracardiac echocardiography can provide images of excellent quality for guidance of the procedure. In this review, we discuss the role of imaging for transcatheter ASD closure, focusing on echocardiography.