Zhonghua xin xue guan bing za zhi · 2014
[Feasibility of transcatheter closure of atrial septal defect under the guidance of transthoracic echocardiography].
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Pan Xiangbin, Li Shoujun, Hu Shengshou, Ouyang Wenbin, Zhang Fengwen, Zhang Dawei, Tian Pengsheng, Zhang Yanbo, Pang Kunjing
Аннотация
OBJECTIVE: To explore the feasibility of transcatheter closure of atrial septal defect (ASD) under transthoracic echocardiography (TTE) guidance.
METHODS: Retrospective analysis was performed in 65 patients with simple ASD who underwent transcatheter closure under echocardiography guidance in Fuwai hospital from February to August 2013. They were divided into TTE group (n = 30) and transesophageal echocardiography (TEE) group (n = 35). The TTE group patients who underwent localized anesthesia or basal anesthesia received transcatheter closure of ASD under the guidance of TTE. The TEE group patients who underwent tracheal intubation and general anesthesia received transcatheter closure of ASD under the guidance of TEE. The patients were followed up with TTE and electrocardiogram at one month after procedure at outpatient department.
RESULTS: In the TTE group, 28 occluders were implanted successfully and 2 patients were subsequently switched to TEE guidance because of unclear TTE images, and the occluder implantation in these 2 patients was successful. There were no obvious differences in age, sex, body weight, ASD size, and time of hospital stay between the two groups (all P > 0.05) . Compared with TEE group, the TTE group had a significantly shorter operation time ((52.77 ± 9.00 ) min vs. (60.11 ± 9.15) min, P < 0.05), respirator ventilation duration ((0.25 ± 0.95) h vs. (3.17 ± 0.69) h, P < 0.05), and stay time in ICU ((1.50 ± 1.96) h vs. (16.43 ± 6.99) h, P < 0.05). The dose of propofol required was significantly lower in the TTE group compared to TEE group ((2.41 ± 2.97) mg/kg vs. (9.43 ± 3.70) mg/kg, P < 0.05). The patients in both groups had no complications such as residual shunt, peripheral vascular injury or cardiac perforation at the time of hospitalization.No complications, such as occluder dislocation, residual shunt, or pericardial effusion were seen during follow-up at one month post procedure in both groups.
CONCLUSION: Transcatheter closure of ASD under TTE guidance is feasible and has a broad application prospects.
METHODS: Retrospective analysis was performed in 65 patients with simple ASD who underwent transcatheter closure under echocardiography guidance in Fuwai hospital from February to August 2013. They were divided into TTE group (n = 30) and transesophageal echocardiography (TEE) group (n = 35). The TTE group patients who underwent localized anesthesia or basal anesthesia received transcatheter closure of ASD under the guidance of TTE. The TEE group patients who underwent tracheal intubation and general anesthesia received transcatheter closure of ASD under the guidance of TEE. The patients were followed up with TTE and electrocardiogram at one month after procedure at outpatient department.
RESULTS: In the TTE group, 28 occluders were implanted successfully and 2 patients were subsequently switched to TEE guidance because of unclear TTE images, and the occluder implantation in these 2 patients was successful. There were no obvious differences in age, sex, body weight, ASD size, and time of hospital stay between the two groups (all P > 0.05) . Compared with TEE group, the TTE group had a significantly shorter operation time ((52.77 ± 9.00 ) min vs. (60.11 ± 9.15) min, P < 0.05), respirator ventilation duration ((0.25 ± 0.95) h vs. (3.17 ± 0.69) h, P < 0.05), and stay time in ICU ((1.50 ± 1.96) h vs. (16.43 ± 6.99) h, P < 0.05). The dose of propofol required was significantly lower in the TTE group compared to TEE group ((2.41 ± 2.97) mg/kg vs. (9.43 ± 3.70) mg/kg, P < 0.05). The patients in both groups had no complications such as residual shunt, peripheral vascular injury or cardiac perforation at the time of hospitalization.No complications, such as occluder dislocation, residual shunt, or pericardial effusion were seen during follow-up at one month post procedure in both groups.
CONCLUSION: Transcatheter closure of ASD under TTE guidance is feasible and has a broad application prospects.