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Appropriate selection of echocardiographic guidance for transcatheter atrial septal defect closure
- Source :
- The International Journal of Cardiovascular Imaging. 36:855-863
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Transesophageal echocardiography (TEE) under general anesthesia (GA) or intracardiac echocardiography (ICE) under sedation is usually used for echocardiographic guidance during transcatheter atrial septal defect (ASD) closure. However, appropriate selection of guidance has not been fully established. Our study aimed to evaluate whether selection of guidance depending on anatomic ASD features and TEE tolerability under sedation contributes to procedure success. On the basis of anatomic ASD characteristics and TEE tolerability under sedation during the pre-procedural TEE, we selected either TEE, ICE, or combined TEE and ICE under moderate-to-deep sedation or TEE under GA for guidance. Anatomic characteristics of the defect, medical costs, complications, and primary outcomes for these four different types of guidance were analyzed. A total of 154 patients were classified into four guidance groups depending on the results of diagnostic TEE under sedation; 11 patients were scheduled for the procedure under GA in advance. Procedures were successfully completed in all but two patients in whom closure guided by TEE under sedation was attempted for an extremely large defect or extensive superior rim deficiency. Two patients who underwent TEE or combined TEE and ICE guidance under sedation were converted to ICE-only guidance due to desaturation or excessive body movement. Device dislodgement was not observed during the procedure or during median follow-up of 1188 days [interquartile range 577-1831]. Appropriate selection of guidance might contribute to successful transcatheter ASD closure.
- Subjects :
- Adult
Male
Cardiac Catheterization
medicine.medical_specialty
Intracardiac echocardiography
Under sedation
Adolescent
Septal Occluder Device
Sedation
Clinical Decision-Making
Conscious Sedation
Anesthesia, General
030204 cardiovascular system & hematology
Heart Septal Defects, Atrial
Young Adult
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Interquartile range
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Hospital Costs
Child
Cardiac imaging
Aged
business.industry
Patient Selection
Body movement
Atrial septal defect closure
Middle Aged
Surgery
Treatment Outcome
Tolerability
Child, Preschool
Female
Deep Sedation
medicine.symptom
Cardiology and Cardiovascular Medicine
business
human activities
Echocardiography, Transesophageal
Subjects
Details
- ISSN :
- 15730743 and 15695794
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- The International Journal of Cardiovascular Imaging
- Accession number :
- edsair.doi.dedup.....8bda0e5d68f79e8eb0d5efd2978b1654