Percutaneous device closure of atrial septal defect with totally transthoracic echocardiography guide, without x-ray machine

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Abstract

The present study investigated the feasibility of totally transthoracic echocardiography-guided percutaneous device occlusion of atrial septal defects (ASDs) without using x-ray equipment.

Between September and December 2014, we performed totally transthoracic echocardiography-guided percutaneous device occlusion for 20 patients with secundum ASD without using x-ray equipment. We carried out percutaneous femoral vein puncture, used a specialized delivery sheath during operation, and closed the ASD by releasing an occluder.

All 20 patients experienced successful occlusion and smoothly went through the perioperative period. The average procedure time ranged from 30 to 40 minutes (32.4 ± 3.5 minutes), and the size of the implanted occluder ranged from 20 to 38 mm (25.4 ± 5.8 mm). No occluder displacements, residual fistula, or thrombus-related complications after the procedure. There was no clinical death, no arrhythmia, no hemolysis, no infection, or embolism during patients’ hospitalization and the follow-up period.

Totally transthoracic echocardiography-guided percutaneous device occlusion of ASDs without the use of x-ray equipment may be safe and feasible.

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Most cited references 17

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Percutaneous Closure of Atrial Septal Defects Under Transthoracic Echocardiography Guidance Without Fluoroscopy or Intubation in Children.

Sheng-Shou Hu, Xiang-Bin Pan, Wen-Bin Ou-Yang … (2015)

Demonstrate the benefits of percutaneous atrial septal defect (ASD) closure under guidance of transthoracic echocardiography (TTE) without fluoroscopy.

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Amplatzer septal occluder closure of atrial septal defect: evaluation of transthoracic echocardiography, cardiac CT, and transesophageal echocardiography.

Chien-Chiao Huang, Benjamin Yip, Di Liang … (2009)

The purpose of this study was to compare transthoracic echocardiography (TTE), cardiac CT, and transesophageal echocardiography (TEE) in the evaluation of secundum atrial septal defect (ASD) for closure with an Amplatzer septal occluder in pediatric patients. The cases of 28 children with ASD initially diagnosed with TTE who were scheduled for cardiac CT for evaluation for insertion of an Amplatzer septal occluder under TEE guidance were reviewed. The patients were divided into a group with small ASD (long axis or = 1.5 cm). Measurements of the ASD obtained at TTE, cardiac CT, and TEE were compared. Kappa statistics were used to correlate the diagnostic value of cardiac CT assessed by two independent reviewers. After cardiac CT, six patients were excluded from occluder implantation; therefore, 22 patients (seven boys, 15 girls; mean age, 4.95 years; range, 2-11 years) were included in the study. There were no significant differences in the ages and sexes of the patients in the two groups, but pulmonary-to-systemic blood flow ratio in the large-ASD group was significantly greater than that in the small-ASD group (3.54 +/- 1.43 vs 1.89 +/- 0.36; p = 0.001). With respect to long- and short-axis lengths of the ASD, interatrial septum, and four rims and to detection of rim deficiency, neither group had a significant difference between cardiac CT findings at ventricular end-systole and TEE findings. The long axis of the ASD in the large-ASD group measured at cardiac CT at end-systole and TEE was significantly longer than the long axis measured at TTE (p = 0.012). A high diagnostic score with good interobserver correlation (kappa = 0.674-0.750) validated the feasibility of cardiac CT in the assessment of ASD for closure with an Amplatzer septal occluder. The long axis of a large ASD can be underestimated at TTE. Cardiac CT seems comparable with TEE in the assessment of ASD and is helpful in noninvasive evaluation for Amplatzer septal occluder implantation, especially for large ASD.

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Evaluation of different minimally invasive techniques in the surgical treatment of atrial septal defect.

Hong-Yan Luo, Jing-jing Wang, Chenhui Qiao … (2014)

Minimally invasive cardiac surgery is becoming a safe and cosmetic alternative to standard median sternotomy (SMS). In the present retrospective study, we reviewed our results and experience with the totally thoracoscopic (TTS) and right vertical infra-axillary thoracotomy (RVIAT) techniques for atrial septal defect closure compared with SMS.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: November 2016

Publication date (Electronic): 04 November 2016

Volume: 95

Issue: 44

Electronic Location Identifier: e5256

Affiliations

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, P.R. China.

Author notes

[∗ ]Correspondence: Hua Cao, Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road, Fuzhou, P. R. China, (e-mail: caohua0791@ 123456163.com ).

Article

Accession ID: 05256

DOI: 10.1097/MD.0000000000005256

PMC ID: 5591136

PubMed ID: 27858888

SO-VID: 6973e249-dd9e-404e-9dca-44906d8e485d

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

History

Date received : 29 November 2015

Date revision received : 2 October 2016

Date accepted : 10 October 2016

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Keywords: cardiac intervention,chd,septal defects

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Keywords: cardiac intervention, chd, septal defects

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