Objectives: It was our aim to evaluate whether the defect area plays a crucial role in successful device closure of atrial septal defects (ASDs). Methods: The long and short diameters of the defect were measured on en-face images. The defect area was then measured by planimetry. The device size compared to the defect length and defect area was analyzed in each group. Results: There were 22 patients in the circular group and 45 patients in the noncircular group. The defect area did not differ between the groups (201.6 ± 107.1 vs. 245.6 ± 127.6 mm2). Although the length between the device size and the long diameter differed between the groups (3.4 ± 2.0 vs. 0.8 ± 3.7 mm; p = 0.003), there was no difference in the ratio of the device area compared to the defect area, which was constant even in the noncircular defect (1.73 ± 0.41 vs. 1.72 ± 0.53 mm2; p = 0.947). The device size was positively correlated with the defect area (p < 0.01). Conclusion: The defect area measured by planimetry on en-face images might be useful in selecting the device size for transcatheter closure of ASDs.

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