{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:01:26Z","timestamp":1781164886058,"version":"3.54.1"},"reference-count":30,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Transcatheter secundum atrial septal defect (ASD) closure is the preferred approach in the majority of cases. Building skill sets through understanding complex ASD anatomies is essential. Such anatomies include ASD associated with aneurysmal septum, multiple defects, absence of anterosuperior or posteroinferior rim and malaligned septum This expert-based review will focus on the key role of advanced TOE imaging during transcatheter ASD closure in challenging anatomies. We describe our institutional experience and provide a practical approach of how to plan and navigate device choice and its delivery to ensure optimal outcomes.<\/jats:p>","DOI":"10.3390\/jcdd13060261","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:57:17Z","timestamp":1781161037000},"page":"261","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Pivotal Role of Advanced Echocardiography in Transcatheter Closure of Challenging Secundum Atrial Septal Defect Anatomies: An Expert-Based Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Bushra Shahida","family":"Rana","sequence":"first","affiliation":[{"name":"St Thomas\u2019 and Royal Brompton Hospital, Guy\u2019s and St Thomas Hospitals NHS Trust, Westminster Bridge Road, London SW1 7EH, UK"},{"name":"Cleveland Clinic London, 33 Grosvenor Place, London SW1X 7HY, UK"},{"name":"National Heart & Lung Institute, Hammersmith Hospital, Imperial College London, London SW7 2BX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-3241","authenticated-orcid":false,"given":"Brian","family":"Clapp","sequence":"additional","affiliation":[{"name":"St Thomas\u2019 Hospital, Guy\u2019s and St Thomas Hospitals NHS Trust, Westminster Bridge Road, London SW1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0883-5614","authenticated-orcid":false,"given":"Iqbal Saeed","family":"Malik","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London W12 0AH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref_1","first-page":"78","article-title":"Secundum Atrial Septal Defect Closure in Adults in the UK","volume":"11","author":"English","year":"2025","journal-title":"Eur. 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