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THE SAFE AND EFFECTIVE GUIDANCE BY INTRACARDIAC ECHOCARDIOGRAPHY FOR TRANSCATHETER CLOSURE IN LARGE ATRIAL SEPTAL DEFECTS
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Abstract
Background: Percutaneous septal closure is the preferred treatment strategy. However, large atrial septal defect is always a challenge for the operator. Esophageal echocardiography is the imaging technique used as a guide in the closure of a large atrial septal defect. However, patients should be pre-anesthetized and adequately secured with airway protection. Intracardiac echocardiography guided closure of a large atrial septal defect is a new technique that has been shown to be safe and effective. Objective: Evaluating the safety and efficacy of transcatheter closure of large atrial septal defect under intracardiac echocardiography guidance. Subjectives and method: 55 patients with large atrial septal defect were treated at the cardiovascular centre, Cho Ray Hospital. The prospective, open label, non-randomized, longitudinal study. Result: 55 patients had mean age of 41.78 ± 11.64 years old (23 – 62 years), female 85.45%. The mean diameters of the atrial septal defect were 24.14 ± 3.42 mm (transesophageal echocardiography) and 27.89 ± 4.27 mm (intracardiac echocardiography) with P<0.001. The mean diameter of the device is 29.96 ± 4.40 mm (20 - 37 mm). All patients were evaluated in-hospital, 1 month and 3 months, recording 100% of the cases technically successful. We followed up in-hospital patients and recorded 01 case of atrial fibrillation (1.82%) who were successfully converted and maintained sinus rhythm during follow-up; In addition, no other adverse events were recorded at 3 months. After a 3-month follow-up period, we recorded patients with improved dyspnea according to NYHA class as well as the right ventricular diameter and pulmonary artery pressure on echocardiography. Conclusion: Our study has shown that the percutaneous closure of large secondary atrial septal defects in the 20–37 mm diameter range under intracardiac echocardiography guidance can be performed safely and effectively.
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Keywords
atrial septal defect, large atrial septal defect, intracardiac echocardiography
References
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