Document Detail


Intracardiac echocardiography evaluation in secundum atrial septal defect transcatheter closure.
MedLine Citation:
PMID:  12491014     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was designed to assess the balloon sizing maneuvers and deployment of an Amplatzer Septal Occluder (ASO). In addition, intraprocedural balloon sizing was compared with off-line intracardiac echocardiographic measurements. METHODS: The intracardiac echocardiography (ICE) measurements were: maximum transverse and longitudinal atrial septal defect (ASD) diameters in the aortic valve and four-chamber planes; area of the ASD and its equivalent circle diameter. Thirteen consecutive patients underwent transcatheter implantation of an ASO device using ICE guidance under local anesthesia. The device matching the balloon sizing diameter of the defect was implanted. Qualitative ICE assessment of the ASO devices implanted was performed off line. RESULTS: The mean equivalent circle diameter predicted by ICE was 24.40 +/- 5.61 mm and was significantly higher (p = 0.027) than the ASD measured by balloon sizing (21.38 +/- 5.28 mm). Unlike previous studies we did not find any correlation between the two measurements (correlation coefficient = 0.47). Only four of the 13 patients had optimal device positioning as shown by the qualitative ICE evaluation, whereas the remaining nine patients had inadequate device placement. This resulted in a waist diameter that was an average 26.1% undersized in seven patients and 12.7% oversized in two patients. Five of the seven patients with an undersized device had ASO-atrial septum misalignment with leftward device deviation. CONCLUSION: The ICE images allowed careful measurement of the dimensions of the ASD and accurately displayed the spatial relations of the ASO astride the ASD. Moreover, use of the ICE measurement led to selection of a different size of device in comparison with those of balloon sizing. The clinical benefit of this new approach needs to be rigorously tested.
Authors:
Mario Zanchetta; Luigi Pedon; Gianluca Rigatelli; Antonio Carrozza; Marco Zennaro; Roberta Di Martino; Eustaquio Onorato; Pietro Maiolino
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Publication Detail:
Type:  Journal Article     Date:  2002-12-20
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  26     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2003 Jan-Feb
Date Detail:
Created Date:  2003-03-18     Completed Date:  2003-07-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  52-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Disease, Cittadella General Hospital, Cittadella, Padua, Italy. emodinacit@ulss15.pd.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Balloon Occlusion*
Echocardiography*
Female
Heart Catheterization*
Heart Septal Defects, Atrial / therapy*,  ultrasonography*
Humans
Male
Middle Aged
Ultrasonography, Interventional

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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