Initial experience with intracardiac echocardiography guidance in transcatheter closure of interatrial communication (atrial septal defect, patent foramen ovale, fenestrated Fontan) in Saudi Arabia

the recent development of intracardiac echocardiography (iCe) has added a further dimension to the imaging modalities avail-able to the cardiologist. intracardiac ultrasound or echocar-diography has been in existence since the 1970s with clinical use for visualization of the coronary arteries since the 1980s.1,2 early ultra-sound-tipped catheters used high frequency for detailed imaging of the coronary artery lumen and wall. However, these ultrasound-tipped catheters lacked good depth penetration, and color and pulse Doppler capabilities. With the introduction of lower frequency catheters, an in-crease in depth penetration was possible.The initial experience with the use of the catheter for guiding device closure of secundum atrial septal defect (ASD) and patent foramen ovale (pfo) has been recently de-scribed.3 We report our experience using this new modality in guiding trans-catheter closure of ASD, pfo and fenestrated fontan.We avoided transesophageal echocardiography (tee) and general anesthesia (except for that needed for comparison of tee and iCe).We assessed the feasibility and accuracy of iCe in guiding the percuta-neous closure of intra-atrial communications and the success of device deployment at prince Sultan Cardiac Center, riyadh, Saudi Arabia.