Influence of Echocardiographic Guidance on Positioning of the Buttoned Occluder for Transcatheter Closure of Atrial Septal Defects.

Ideal position of the buttoned device for occlusion of atrial septal defects was achieved more often with transesophageal than with transthoracic echocardiographic guidance (10/11 vs 7/23; P = 0.001). Patients with ideal device position were less likely to have residual shunts, device unbuttoning, or atrioventricular valve regurgitation (2/17 vs 11/17; P = 0.002). We therefore recommend the use of transesophageal echocardiography to guide implantation of the buttoned device. (ECHOCARDIOGRAPHY, Volume 13, March 1996)