Methods
Patients : We retrospectively studied 156 cases (74 males and 82 females) who underwent trans-jugular transcutaneous closure of ASD with an adjustable curved sheath under echocardiography guidance in the Heart Center of Henan Province People’s Hospital from January 2016 to December 2022. All patients were diagnosed with ASD by echocardiography. According to the guidelines for interventional treatment of congenital heart disease(13) . The inclusion criteria were as follows: 1) secundum ASD; 2) increased right ventricular volume load; 3) left-to-right shunt; 4) in addition to the absence or insufficiency of the stump margin of atrial septum on the aortic side, the stump margin of the superior and inferior vena cava, the stump margin opposite the aortic root, and the stump margin of the mitral valve annulus should be ≥ 3 mm; 5) the maximum extension diameter of the atrial septum was larger than the left atrial surface diameter of the selected occluder. The exclusion criteria were as follows:1) primum ASD; 2)Severe pulmonary hypertension; 3)age < 6 months; 4)the stump margin of the superior and inferior vena cava, the stump margin opposite the aortic root, and the stump margin of the mitral valve annulus should be < 3 mm
All patient and family members were informed and agreed to performance of this operation.
Intraoperative TEE was performed using GE Vivid EQ5 portable ultrasonography (GE Healthcare Biosciences, Piscataway, NJ, USA). The occluders and adjustable bent sheaths were produced by Shenzhen LifeTech Scientific Corporation China. The conveying device included loading sheaths and push cables (Figure 1).