Preliminary experience using transthoracic echocardiography guiding percutaneous closure of ruptured right sinus of Valsalva aneurysm

• Published in: Chinese medical journal Vol. 124; no. 10; pp. 1477 - 1482
• Main Authors: Li, Yue, Wang, Guang-Yi, Wang, Zhi-Feng, Guo, Liang
• Format: Journal Article
• Language: English
• Published: China Department of Ultrasound, Chinese People's Liberation Army General Hospital, Beijing 100853, China%Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China 20.05.2011
• Subjects: Adult; Echocardiography - methods; Female; Humans; Male; Middle Aged; Sinus of Valsalva - diagnostic imaging; Sinus of Valsalva - surgery; 关闭; 动脉瘤; 大直径测量; 引导; 最大直径; 破裂; 穿刺; 超声心动图; percutaneous catheter closure; transthoracic echocardiography; ruptured aneurysm of sinus
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.10.007

Background In the 21st century, minimally invasive treatment is one of the main developmental directions of medical sciences. It is well known that the echocardiography plays an important role during interventional treatments of some structural heart diseases. Because the ruptured right sinus of the Valsalva aneurysm （RRSVA） is a rare disease, there were few reports about percutaneous catheter closure of RRSVA. This study aimed to sum up our experience with transthoracic echocardiography （TTE） during percutaneous catheter closure of RRSVA.Methods Five RRSVA cases were treated with percutaneous catheter closure. The whole procedure was guided and monitored by TTE and fluoroscopy. The maximum diameter of the RRSVA was measured by TTE before and after the catheter passed through the rupture site. A duct occluder 2 mm larger than the maximum diameter was chosen. The closure effects were evaluated with TTE and fluoroscopy immediately after the occluding device was deployed. All patients were followed up by TTE for 8 to 30 months.Results Before the catheter passed through the rupture site the maximum diameter of the RRSVA measured with TTE and aortography were （7.9 ±2.1） mm and （7.8 ± 1.8） mm. After the catheter passed through the rupture site the maximum diameter measured with TTE was （11.2 ± 3.2） mm, which was significantly larger than before the procedure （P 〈0.05）. The percutaneous catheter closure was successful in four cases and failed in one. Compared to the aortography the TTE was better at distinguishing residual shunts from aortic valve regurgitation immediately after the occluding device was deployed. There were no complications during 8 to 30 months of follow-up.Conclusion Transthoracic echocardiography can play an important role during percutaneous catheter closure of RRSVA,especially for estimating the size of the RRSVA after the catheter passes through the rupture site, and differentiating residual shunt from aortic valve regurgitation immediately after the occluding device is deployed