Transbasilic Approach for Percutaneous Closure of an Atrial Septal Defect

J INVASIVE CARDIOL 2021;33(10):E835.

Key words: atrial septal defect, transbasilic approach

Atrial septal defect (ASD) closure is indicated in the presence of a significant left-to-right shunt. The preferable treatment is transcatheter closure, usually performed by transfemoral route. However, in the case of an interrupted inferior vena cava (IVC), the standard percutaneous approach can be troublesome. The authors report a case of a 55-year-old woman with an ostium secundum ASD with a significant left-to-right shunt at rest (Qp/Qs, 1.6). Her diagnosis and treatment are shown in Figure 1. The cardiac computed tomography scan showed an interrupted IVC above the renal veins. The patient was referred for percutaneous defect closure, through an ultrasound-guided right basilic vein access. The procedure was performed using transesophageal echocardiography guidance. A 7 Fr sizing balloon and Amplatzer TorqVue delivery system (Abbott) were introduced through the basilic vein. A 15 mm Amplatzer septal occluder device was used with a good final result.

To our knowledge, this is the first case in the literature featuring the transbasilic peripheral vein approach for ASD closure.

From the ¹Serviço Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; and ²Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

Manuscript accepted May 10, 2021.

The authors report patient consent for the images used herein.

Address for correspondence: João Lopes, MD, Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Morada: Praceta Prof Mota Pinto, 3000-075 Coimbra, Portugal. Email: joaopedrlop@gmail.com