Comparison of Devices for Atrial Septal Defects Closure: A Pilot Study

Inclusion Criteria: * ≥18 years old referred for percutaneous (secundum) ASD closure with right atrial and ventricular enlargement; and * clinically significant left-to-tight shunt (Qp:Qs≥1.5:1), or * evidence of paradoxical embolism (with a TEE defect \>10mm), * written informed consent Exclusion Criteria: * TEE/CCT/CMR defect diameter \>30mm, * rim sizes of \< 5 mm to the coronary sinus, inferior vena cava rim, an atrioventricular valve, or the right upper pulmonary vein, * multiple defects, * complex congenital heart disease requiring surgical repair within 3 years of device placement, * Eisenmenger-syndrome, * recent myocardial infarction PCI/CABG \< 6 weeks, * demonstrated intra cardiac thrombi on echocardiography (especially LA or LAA thrombi), or atrial tumor * known occluded bilateral femoral veins/IVC, * pulmonary artery systolic pressure more than half the systemic systolic arterial pressure * recent pelvic venous thrombosis * serious comorbidity with life expectancy \<3 years (e.g., non-skin cancers not in remission, advanced renal failure serum creatinine \>160 umol/L) * patients whose size or condition would cause the patient to be a poor candidate choice for cardiac catheterization (e.g., too small for echocardiographic imaging probe, catheter size, vascular size, active infection, body weight \< 8 kg) * serious infection in \< 6 weeks producing bacteremia (e.g. sepsis), active endocarditis, or any other infection that cannot be treated successfully prior to device implantation (patient must have negative blood cultures off antibiotics for 1 week prior to procedure), * active GI bleed \< 6 weeks, * bleeding disorder, untreated ulcer, or any other contraindications to aspirin therapy, unless another antiplatelet agent can be administered for 6 months * previous stroke in the past 12 months, * documented chronic atrial fibrillation or \>2 episodes of documented paroxysmal atrial fibrillation in the last 12 months, * pregnancy or breastfeeding, plan to become pregnant within the next 6 months, not using an effective method of birth control in premenopausal women, * documented nickel/titanium allergy, or intolerance to contrast agents.