Document Detail

Comparisons of mechanical versus phase-array intracardiac echocardiography-assisted transseptal puncture in patients with dilated left atrium undergoing percutaneous transvenous mitral commissurotomy.
MedLine Citation:
PMID:  20875620     Owner:  NLM     Status:  In-Process    
BACKGROUND: Percutaneous transvenous mitral commissurotomy (PTMC) is an effective treatment for mitral stenosis, but transseptal puncture carries a certain risk of complications. Our previous report has shown the effectiveness of phase-array intracardiac echocardiography (ICE)-guided transseptal puncture in patients with dilated left atrium undergoing PTMC. However, there are few reports comparing the new-generation mechanical versus phase-array ICE-guided transseptal puncture in PTMC.
METHODS: Between March 2007 and March 2008, 6 consecutive patients with symptomatic mitral stenosis with dilated left atrium (range, 4.1-6.1 cm) underwent transseptal puncture by mechanical ICE guidance in PTMC by the same experienced operator. The procedural, echocardiographic and clinical results were retrospectively retrieved and analyzed. In addition, phase-array ICE-guided transseptal cases (n = 7), which included consecutive cases from May to December 2008, were compared.
RESULTS: All 6 patients could have fossa ovalis visualized by ICE, and none of them had false transseptal puncture. Mechanical ICE provided a panoramic wider view of the interatrium septum, and offered better knowledge of the needle's geographic contact to the fossa ovalis than did the phase-array system. The fluoroscopic time of PTMC in the mechanical ICE-guided group (37 ± 9 minutes, n = 6) was similar (p = 0.465) to that of phase-array guidance (31 ± 15 minutes, n = 7).
CONCLUSION: Mechanical ICE is effective in guiding transseptal puncture in PTMC.
Kae-Woei Liang; Yun-Ching Fu; Wen-Lieng Lee; Kuo-Yang Wang; Chih-Tai Ting; Sheng-Ling Jan; Wei-Wen Lin; I-Hsiang Lin
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  73     ISSN:  1728-7731     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  471-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier. Published by Elsevier B.V. All rights reserved.
Cardiovascular Center, Taichung Veterans General Hospital, #160 Section 3 Taichung Kang Road, Taichung, Taiwan.
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Comment In:
J Chin Med Assoc. 2010 Oct;73(10):509-10   [PMID:  21051025 ]

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