Transcatheter closure of complex atrial septal defects is efficient under intracardiac echocardiographic guidance

Assaïdi, Anass; Sumian, Marion; Mauri, Lucia; Mancini, Julien; Ovaert, Caroline; Salaun, E.; Habib, Gilbert; Fraisse, Alain

doi:10.1016/j.acvd.2014.06.010

Cited by 25 publications

(21 citation statements)

References 22 publications

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“…Trans-esophageal echocardiography (TEE) or intracardiac echocardiography (ICE) are widely used to guide the procedure (4,5). However, TEE use may lead to oropharyngeal and oesophageal traumas (6)(7)(8), and ICE is expensive and require an additional large venous access (9). Given a good echocardiographic window in children, transthoracic echocardiographic (TTE) guidance has been proposed (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Baruteau¹,

Hascoët²,

Fraisse³

2017

J. Thorac. Dis.

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Background: 2D-transesophageal echocardiography (TEE) is routinely performed to guide percutaneous ASD closure in children. We aimed to assess whether two-dimensional (2D)-transthoracic echocardiography (TTE) is a safe alternative for assessment and guidance of atrial septal defect (ASD) closure in unselected children.Methods: We performed a retrospective single-center study including 389 consecutive children aged Results: ASDs were larger and rims deficiencies were more frequent in the TTE-guided group. The procedure was successful in 376 patients [96.7%; 95% confidence interval (CI), 94.4-98.2%]. The success rate tended to be higher in the TTE-versus TEE-guided group (98.0% versus 94.0%, P=0.069). Device migration occurred in 4 patients (1.0%; 95% CI: 0.3-1.6%), all after TEE-guided procedure (P=0.013).Early major adverse events were observed in 5 patients (1.3%; 95% CI: 0.4-3.0%), all in the TEE group (P=0.004). Fluroroscopic time and irradiation dose were not different among the 2 groups (P=0.450 and P=0.130 respectively). After a median follow-up of 7 years (range, 1-16 years), no adverse events was reported. One (0.3%, 95% CI: 0-1.4%) 12-year-old patient developed atrial fibrillation 5 years after the procedure. Pregnancies were uneventful in 72 cases.Conclusions: When a balloon sizing is performed, 2D-TTE imaging is as efficient as 2D-TEE to guide percutaneous ASD closure in children. The procedure can safely be done in spontaneously breathing children under TTE guidance alone in experienced centers.

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Section: Introductionmentioning

confidence: 99%

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Baruteau¹,

Hascoët²,

Fraisse³

2017

J. Thorac. Dis.

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“…Only a few previous reports validated percutaneous closure in cases with deficient rims. [18][19][20][21] Deficient aortic or superior rim may cause erosion of aortic valve and deficient posterior or inferior rim may cause displacement of occluder. However, using more accurate assessment tools is the only way to improve the success rate in percutaneous closure procedure.…”

Section: Discussionmentioning

confidence: 99%

“…However, using more accurate assessment tools is the only way to improve the success rate in percutaneous closure procedure. 21 In this study, small-edge occluder (right disc＞waist 3 mm different from normal occluder right disc > waist 5 mm) was employed and area rule was adopted for cases with deficient aortic or superior rim because of no "unbutton effect" in intraoperative device closure. Stitching enhancement for cases with deficient posterior or inferior rim strengthens the stability of occluder to avoid from displacement.…”

Section: Discussionmentioning

confidence: 99%

“…Deficient rim, especially deficient posterior–inferior rim is the another major reason for suggesting to surgery. Only a few previous reports validated percutaneous closure in cases with deficient rims . Deficient aortic or superior rim may cause erosion of aortic valve and deficient posterior or inferior rim may cause displacement of occluder.…”

Section: Discussionmentioning

confidence: 99%

“…However, using more accurate assessment tools is the only way to improve the success rate in percutaneous closure procedure 21. However, using more accurate assessment tools is the only way to improve the success rate in percutaneous closure procedure 21.…”

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confidence: 99%

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Strategy of treating secundum atrial septal defect not referred to percutaneous closure

Zhang¹,

Yang

et al. 2019

Congenital Heart Disease

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Objective: To evaluate safety and effectiveness of intraoperative device closure for secundum atrial septal defect (ASD) not referred to percutaneous closure. Design and Patients:From April 2010 to December 2018, 231 secundum ASD children (≤14 years) directly recommended to surgical repair were enrolled in this study.These patients were divided into two groups according to the parents' choice based on surgeons' recommendation. Follow-up evaluations were adopted at 2 weeks, 3 months, 6 months, and 12 months after the procedure and yearly thereafter. In Group A, 127 patients underwent an initial attempt at device closure. In Group B, 104 patients underwent a repair procedure under cardiopulmonary bypass. Results: All patients survived. Group A had lower values of operation time, mechanical ventilation time, cardiac intensive care unit duration and amount of blood transfusion. Nevertheless, postoperative hospitalization time between two groups showed no statistical difference. In group A, 109 (85.83%) patients were successfully occluded, whereas 18 (14.17%) patients were converted to open-heart surgery. No severe complications occurred in the follow-up period.Conclusion: Intraoperative device closure is safe, effective procedure for selected cases with secundum ASDs which were not referred to percutaneous closure because of more suitable occluder selection, no "unbutton effect" and stitching enhancement. K E Y W O R D Schildren, intraoperative device closure, percutaneous closure, secundum ASD

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Perioperative Imaging

Garg¹,

Lubin²

2017

Congenital Heart Disease in Pediatric and Adult Patients

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Transcatheter closure of complex atrial septal defects is efficient under intracardiac echocardiographic guidance

Abstract: Transcatheter closure of complex ASDs is safe and effective under intracardiac echocardiographic guidance.

Cited by 25 publications

References 22 publications

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

Strategy of treating secundum atrial septal defect not referred to percutaneous closure

Perioperative Imaging

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