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RESULTS OF THE STUDY ON THE APPLICATION OF INTRACARDIAC ECHOCARDIOGRAPHY (ICE) IN THE DIAGNOSIS AND TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECTS AT CHO RAY HOSPITAL
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Abstract
Background: Percutaneous septal closure is the preferred treatment strategy. Esophageal echocardiography is an imaging technique used to diagnose and evaluate the anatomy of the atrial septal defect as well as assist in the procedure to close the atrial septal defect; However, the patient needs to be pre-anesthetized and have adequate airway protection during the procedure. Intracardiac echocardiography is a new imaging technique used to evaluate atrial septal defect anatomy and guide atrial septal defect closure. Objective: Evaluate the correlation of intracardiac echocardiography and transesophageal echocardiography on the assessment of atrial septal defect anatomy. Evaluating the safety and efficacy of transcatheter closure of atrial septal defect under intracardiac echocardiography guidance. Subjectives and method: 40 patients atrial septal defect were treated at the cardiovascular centre, Cho Ray Hospital. The prospective, open label, non-randomized, longitudinal study. Result: 40 patients had mean age of 43,55±12,90 years old (17 – 65 years), female 80%. The mean maximum ASD diameter measured by ICE was significantly larger than by TEE (25.40 ± 3.20 mm vs. 23.88 ± 3.72 mm, p< 0.001). There was a strong correlation between ASD diameter measurements with TEE and ICE with correlation coefficient r= 0.792 (p< 0.001). The ASD diameter measured by TEE and ICE compared with the ASD diameter measured by size balloon both showed a good correlation of 0.547 and 0.909 (p < 0.001). The length of ASD rims measured by TEE was longer than ICE but the difference was not statistically significant. All patients were evaluated in-hospital and 1 month, recording 100% of the cases technical and procedural successes. After a 1-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: There was a strong correlation in assessing atrial septal defect anatomy with TEE and ICE. ICE is a feasible and safe technique, providing the full diameter of the atrial septal defect, the rims of ASD, and the atrial septum. It can replace TEE to guide the diagnosis and intervention closure of atrial septal defect.
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