Imaging-guided transseptal puncture and transcatheter closure of patent foramen ovale/atrial septal defect, ventricular septal defect, and paravalvular leaks

Repairing structural heart diseases without surgery has been a major challenge. The title ‘The Father of Interventional Cardiology’ belongs to William J. Rushkind (1922–1986) who performed atrial balloon septostomy in newborn babies with D-transposition as early as 1968. He also designed devices for the transcatheter closure of atrial defects and of patent ductus arteriosus. The introduction of better devices and skilled operators led to successful procedures which are less traumatic, shorter, and in many cases significantly less expensive. The various modalities of cardiac imaging have become a crucial ingredient of the preprocedural diagnosis, procedural guidance, and the assessment of procedural results and follow-up. This chapter will demonstrate and discuss the role of imaging in several catheter-based procedures that are now commonly practised by the current generation of interventional cardiologists who are involved in structural heart disease.