C  2006, the Authors Journal compilation C  2006, Blackwell Publishing, Inc. Live 3-D Echocardiography in Monitoring Transcatheter Closure of Patent Foramen Ovale Masood Ahmad, M.D., Zening Jin, M.D., Tianrong Xie, M.D., Ildiko Agoston, M.D., Frank Tiller, R.D.C.S., and Barry Uretsky, M.D. Division of Cardiology, University of Texas Medical Branch at Galveston, Texas (ECHOCARDIOGRAPHY, Volume 23, July 2006) Case Report Transesophageal echocardiography (TEE) is routinely used in monitoring transcatheter clo- sure of patent foramen ovale (PFO). 1 However the technique requires mental reconstruction of 2-dimensional images for estimation of the shape and size of PFO. Live 3-D Echocardio- graphy (3-D, Sonos 7500 Philips, Bothel, WA) provides unique en-face views of PFO and has the potential to precisely define its size and shape. 2,3 Address for correspondence and reprint requests: Masood Ahmad, M.D., F.A.C.C., Professor of Medicine, Division of Cardiology, 301 University Blvd, 4.148 McCullough Build- ing, University of Texas Medical Branch, Galveston, TX 77555-0766; Phone: (409) 772-2588; Fax: (409) 772-4982; E-mail: mahmad@utmb.edu Figure 1. En-face view of PFO from the right atrium (RA) obtained from apical view by cropping at the base from the right atrial side. Arrow is pointing to the tricuspid annulus and the arrowhead to the right side of the PFO. A 27-year-old male with history of recur- rent transient ischemic attacks underwent transcatheter closure of PFO. In addition to TEE, 3-D was performed for catheter guid- ance and proper positioning of the Amplatzer occluder device (AGA Medical, Golden Valley, MN). TEE with color/contrast assessment of PFO was used for monitoring during the pro- cedure. Transthoracic full-volume 3-D images were acquired from the apex and cropping planes were applied for immediate visualiza- tion of the PFO, catheter, and the occluder device. 3-D provided excellent anatomical detail of the PFO. In addition, 3-D was helpful in pre- cisely localizing the catheter inside the cardiac chambers and in assessment of proper deploy- ment of the occluder device (Figures 1–3). Api- cal four-chamber view derived from 3-D data set was used as a reference for all image cropping. Vol. 23, No. 6, 2006 ECHOCARDIOGRAPHY: A Jrnl. of CV Ultrasound & Allied Tech. 525