ASD Closure Complication Risk (TEE-based Model) Calculator

ASD Closure Complication Risk (TEE-based Model): Explanation and Clinical Context This tool integrates TEE-derived anatomical predictors associated with adverse outcomes during transcatheter secundum ASD closure, translating them into a structured heuristic for clinical use. The strongest predictor for erosion is the coexistence of aortic rim deficiency and device oversizing > 5 mm. Additional features—multiple rim deficiencies, atrial septal aneurysm or malalignment, and multifenestrated septum—signal increased technical complexity and potential for embolization or residual shunt.

Three-dimensional (3D) TEE provides superior assessment of rim morphology and ASD geometry, improving device size estimation and identifying discordant cases where planned device size appears incongruent with measured area. Large ASDs (≥35 mm) and complex anatomies warrant experienced operators and surgical standby. Evidence Base: Amin Z, et al.

Echocardiographic predictors of cardiac erosion after Amplatzer Septal Occluder placement. J Am Coll Cardiol. 2014.

McElhinney DB, et al. Relative risk factors for cardiac erosion after transcatheter ASD closure. Circulation.

2016. Rana BS, et al. Echocardiography guidance of atrial septal defect closure.

Echo Res Pract. 2018. PMC6174147.

Mani A, et al. Utility of 3D echocardiography for device sizing during ASD closure. J Cardiovasc Imaging.

2023. ASE Guidelines for Echocardiographic Assessment of ASD/PFO. 2015.

Wang J, et al. Predictors of pericardial effusion after ASD closure. EuroIntervention.

2020. Jalal Z, et al. Outcomes after device closure of ASD in children.

JACC: Cardiovasc Interv. 2018. Note: No dedicated, validated TEE-only scoring model for overall ASD closure complications exists in the literature.

This calculator represents a synthesis of evidence-informed heuristics intended for risk communication and procedural planning.