Objective To explore the practical value of intracardiac echocardiography (ICE) on transcatheter closure of patent foramen ovale (PFO). Methods Eight-six patients with PFO were occluded using CardioSEAL under guidance of ICE. A diagnostic ICE was performed for imaging PFO anatomy and monitoring the closure procedure. Measurements of PFO tunnel diameter and length were made by ICE. The device deployment was evaluated by 2-D and color Doppler ICE after release, and then any residual shunt was detected by ICE agitated saline contrast study. Results ICE showed detailed anatomy of PFO and variations in morphology such as redundant secundum septum, convex secundum septum, tissue extension of primum into the fossa ovalis and hypertrophic limbus. Of 86 cases, 85 cases had successful implantation of the CardioSEAL, 1 case failed.Conclusions Transcatheter closure of PFO guided by ICE is a safe, effective, simple and less invasive solution.

Objective To investigate the preliminary experience of transcatheter closure of patent foramen ovale (PFO) under intracardiac echocardiographic (ICE) guidance and to compare the quantitative ICE data with fluoroscopy. Methods 86 patients with PFO were occluded by cardioSEAL~ under the guidance of ICE. Measurements of baseline PFO tunnel diameter and length were taken by ICE. Balloon stretch diameter (BSD) was measured by both ICE and fluoroscopy. The device deployment was guided and evaluated by 2-D and Color Doppler ICE during and after the procedure, and residual shunt was detected by ICE agitated saline contrast study. Results ICE showed detailed anatomy of PFO and the surrounding structures. The baseline PFO tunnel length and diameter measured by ICE were 11?4 mm (3.6-22 mm) and 4?2 mm (0-9 mm), respectively. BSD of PFO measured by ICE and fluoroscopy were 9.2?2.6 mm (5-16 mm) and 9.7?2.8 mm (5-17 mm), respectively. These BSDs showed excellent correlation (r=0.90, P