Assessment of Atrial Septal Defect Size with 3D‐Transesophageal Echocardiography: Comparison with Balloon Method

Abdel-Massih, Tony; Dulac, Yves; Taktak, A; Aggoun, Yacine; Massabuau, P; Elbaz, Meyer; Carrié, Didier; Acar, Philippe

doi:10.1111/j.0742-2822.2005.03153.x

Cited by 48 publications

(22 citation statements)

References 23 publications

(40 reference statements)

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“…[11] Recently, 3D TEE has been used to aid selection of device size. [25] There is good correlation between 3D TEE measurement of maximal diameter and SBD in patients with a single ASD.…”

Section: Discussionmentioning

confidence: 98%

Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

et al. 2011

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Background:Selecting the device size using a sizing balloon could oversize the ostium secundum atrial septal defect (OSASD) with floppy margins and at times may lead to complications. Identifying the firm margins using trans-esophageal echocardiography (TEE) and selecting appropriate-sized device optimizes ASD device closure. This retrospective study was undertaken to document the safety and feasibility of device closure without balloon sizing the defect.Methods:Sixty-one consecutive patients who underwent trans-catheter closure of OSASD guided by balloon sizing of the defect and intra procedural fluoroscopy (group I) and 67 consecutive patients in whom TEE was used for defect sizing and as intraprocedural imaging during device deployment (group II) were compared. The procedural success rate, device characteristics, and complications were compared between the two groups.Results:The procedure was successful in 79.7 % patients. The success rate in group II (60 of 67, 89.6%) was significantly higher than in group I (41 of 61, 67.2 %) (P = 0.002). Mean upsizing of ASD device was significantly lower in group II (P < 0.001). TEE also provided better success rate with smaller device in subjects with large ASD (>25 mm) and in those who were younger than 14 years of age. There were four cases of device embolization (two in each group); of which one died in group II despite successful surgical retrieval.Conclusion:Balloon sizing may not be essential for successful ASD device closure. TEE-guided sizing of ASD and device deployment provides better success rate with relatively smaller sized device.

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“…[11] Recently, 3D TEE has been used to aid selection of device size. [25] There is good correlation between 3D TEE measurement of maximal diameter and SBD in patients with a single ASD.…”

Section: Discussionmentioning

confidence: 98%

Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

et al. 2011

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“…Implanting too large a device may lead to a mushrooming deformity or cardiac perforation or it may increase the risk of device erosion over time,8-10 while using too small a device has been accompanied by device instability, distal embolisation of the device, and residual shunting 11,12. Balloon sizing of the defect has been considered the gold standard for measuring ASD size,13-18 while angiography, transthoracic echocardiography (TTE), two- and three-dimensional transoesophageal echocardiography (TEE), intracardiac echocardiography, and intravascular ultrasound have been tried as guiding methods during the closure procedure 10,14-16,18-20…”

Section: Introductionmentioning

confidence: 99%

A comparison between size of the occluder device and two-dimensional transoesophageal echocardiographic sizing of the ostium secundum atrial septal defect : cardiovascular topics

Haji-Zeinali¹,

Sadeghian²,

Rezvanfard³

et al. 2013

CVJA

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ObjectivesTranscatheter closure of a secundum atrial septal defect (ASD II) has become an effective alternative for surgical treatment. In this study we evaluated the correlation between the two-dimensional transoesophageal echocardiographic (2D TEE) sizing of ASDs and the actual diameter of occluders in patients undergoing device closure.MethodsThe records of 54 patients who underwent transcatheter ASD closure were reviewed. ASD characteristics and maximum defect diameter were evaluated using preprocedure 2D TEE images. Appropriate device size was determined by the balloon sizing method, which measures the balloon occlusive diameter (BOD) via TEE and fluoroscopy. ASD closure was performed under continuous TEE monitoring using the Amplatzer occluder in all patients.ResultsThe mean of the TEE-derived maximum defect diameter was significantly lower than the mean of the BOD (17.8 ± 4.5 vs 22.1 ± 5.1 mm; p < 0.001) and the mean size of the implanted occluder device (17.8 ± 4.5 vs 23.3 ± 5.1 mm; p < 0.001). However, a good correlation was found between the TEE-derived defect size and the BOD (BOD = 0.898 × TEE defect size + 6.212, R = 0.824; p < 0.001) and between the TEE measurement and the final size of the implanted Amplatzer (device size = 0.928 × TEE defect size + 6.853, R = 0.822; p < 0.001).Conclusions2D TEE may provide a good equation to predict the BOD or the size of the occluder device; however, further studies are needed to investigate whether it is feasible to perform transcatheter ASD occlusion without balloon sizing.

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“…Previous 3D studies have described the dynamic nature of the atrial defect size during the cardiac cycle [9][10][11]. Studies have also demonstrated that the defect size determined by 3DTEE correlates well with the balloon sizing method [6,12]. However, these studies have been performed using gated-acquisition methods, which require lengthy acquisitions and tedious off-line reconstructions.…”

Section: Introductionmentioning

confidence: 99%

Assessment of atrial septal defect size and residual rim using real-time 3D transesophageal echocardiography

et al. 2009

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Assessment of Atrial Septal Defect Size with 3D‐Transesophageal Echocardiography: Comparison with Balloon Method

Abstract: Three-dimensional transesophageal echocardiography and transcatheter methods are two complementary techniques for the success of transcatheter ASDs closure.

Cited by 48 publications

References 23 publications

Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

Trans-catheter closure of atrial septal defect: Balloon sizing or no balloon sizing - single centre experience

A comparison between size of the occluder device and two-dimensional transoesophageal echocardiographic sizing of the ostium secundum atrial septal defect : cardiovascular topics

Assessment of atrial septal defect size and residual rim using real-time 3D transesophageal echocardiography

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