Transcatheter closure of multiple atrial septal defects in an adolescent.

Transcatheter closure of secundum atrial septal defect (ASD) using percutaneous approach has become accepted treatment in many cardiac centers. The majority of patients with ASD require a single device for closure, but a small proportion of ASD patients may have multiple defects and these are often considered unsuitable for device closure. Although spatial imaging to understand the relationship between the defects and adjacent structures is provided on 2-D and 3-D trans-esophageal echocardiography (TEE) and cardiac magnetic resonance imaging can help determine the type, location, and size of the ASD and provide direct visualization of the atrial septum anatomy, little is known about the use of devices to close multiple ASD. Here we report the case of a patient with two separate moderate-sized secundum ASD that were successfully closed using two Amplatzer septal occluders, with emphasis on angiography.