Reliability of transthoracic echocardiography in estimating the size of Amplatzer septal occluder and guiding percutaneous closure of atrial septal defects

• Published in: Chinese medical journal Vol. 121; no. 11; pp. 973 - 976
• Main Authors: Li, Gui-shuang, Kong, Guang-ming, Ji, Qiu-shang, Li, Ji-fu, Chen, Yu-guo, You, Bei-an, Zhang, Yun
• Format: Journal Article
• Language: English
• Published: China Key Laboratory of Cardiovascular Remodeling and Function Research,Chinese Ministry of Education and Chinese Ministry of Health Qilu Hospital,Shandong University,Jinan,Shandong 250012.China%Department of Emergency Medicine,Qilu Hospital,Shandong University,Jinan,Shandong 250012.China%Department of Geriatrics Qilu Hospital,Shandong University,Jinan,Shandong 250012.China 05.06.2008
• Subjects: Adolescent; Adult; Aged; Balloon Occlusion - instrumentation; Child; Child, Preschool; Echocardiography - methods; Female; Heart Septal Defects, Atrial - diagnostic imaging; Heart Septal Defects, Atrial - therapy; Humans; Male; Middle Aged; 先天性心脏病; 心脏检查; 超声波心动描记法; 隔膜缺损; congenital heart disease; transthoracic echocardiography; Amplatzer septal occluder; atrial septal defect
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/00029330-200806010-00003

Background In China, transthoracic echocardiography （TTE） is popularly used for pre-intervention examination for atrial septal defect （ASD） and for guiding ASD closure. However, the ability to determine ASD size and the safety and efficacy of l-rE for guiding ASD closure still has not been widely accepted. This study aimed to evaluate the efficacy and safety of l-rE used before, during and after transcatheter ASD closure with Amplatzer septal occluders （ASO）. Methods Sixty-eight subjects （15 men and 53 women; mean age （33.7±17.3） years） were enrolled. TTE was used to measure the diameters and guide transcatheter closure of ASD. The ASD was examined by long-axis view, basal short-axis view, apical four-chamber view and the subcostal view to observe position, diameter and relation with neighbouring structures. The largest diameter was selected as the reference diameter. Patients were divided into 3 groups according to the ASD reference diameter： 22 subjects with ASD diameter 4-14 mm （group A）; 21 subjects with ASD diameter 15-20 mm （group B）; and 25 subjects with ASD diameter 21-33 mm （group C）. Results ASD was occluded successfully in groups A and B. In group C, occlusion failed in 2 cases; 1 case remained with a 3-mm residual shunt sustained until 6-month follow-up. However, at 6-month follow-up, no case of thromboembolism, ASO dislocation or death occurred in the three groups. The diameter of ASD measured by l-rE could accurately predict the ASO size that could successfully occlude the ASD, especially in patients with ASD 〈20 mm. The ASD diameter measured by l-rE correlated well with ASO size （r= 0.925, P〈0.001 ; r=0.976, P〈0.001 ; r=0.929, P〈0.001 respectively）. Conclusions ASD diameter measured by l-rE can accurately estimate the size of the ASO needed for successful closure of ASD. The larger the ASD, the much larger the ASO needed. l-rE is a satisfactory guiding imaging tool for ASD closure.