• Daniel McGrail, Sankalp Sehgal, Mark K Tuttle, Roger Laham, and Kiran Belani.
• Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: dmcgrail@bidmc.harvard.edu.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt B): 3156-3162.

AbstractPATENT FORAMEN ovales (PFOs) and atrial septal defects (ASDs) are 2 examples of interatrial septal pathology.1 The presence of a PFO is a well-known risk factor for cryptogenic stroke.1,2 Newer evidence over the course of the last decade suggests percutaneous device closure of PFOs significantly reduces the subsequent risk of recurrent stroke.2 Among ASDs, the ostium secundum type is the most common pathology and, due to its anatomy, is most amenable to transcatheter closure.1 The tools that are available to percutaneously close these different pathologies vary, and choosing the correct device for the procedure can have significant impact on the clinical outcome. The authors here present a case that highlights how the differentiation of an ASD from a PFO using 2-dimensional (2D) and 3-dimensional (3D) echocardiography can affect the clinical decision-making and outcome in a challenging structural heart disease case.Copyright © 2022 Elsevier Inc. All rights reserved.

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