Journal of Cardiovascular Imaging

  • 제31권4호
  • /
  • Pages.180-187
  • /
  • 2023
  • /
  • 2586-7210(pISSN)
  • /
  • 2586-7296(eISSN)
한국심초음파학회 (Korean Society of Echocardiography)
권호 표지
DOI QR코드

DOI QR Code

Utility of 3D Echocardiography for Device Sizing During Transcatheter ASD Closure: A Comparative Study

  • Avinash Mani (Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)) ;
  • Sivadasanpillai Harikrishnan (Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)) ;
  • Bijulal Sasidharan (Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)) ;
  • Sanjay Ganapathi (Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)) ;
  • Ajit Kumar Valaparambil (Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST))
  • 투고 : 2023.03.17
  • 심사 : 2023.06.27
  • 발행 : 2023.10.27
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

BACKGROUND: Two-dimensional (2D) transesophageal echocardiography (TEE) is commonly used for assessing patients undergoing transcatheter atrial septal defect (ASD) device closure. 3D TEE, albeit providing high resolution en-face images of ASD, is used in only a fraction of cases. We aimed to perform a comparative analysis between 3D and 2D TEE assessment for ASD device planning. METHODS: This was a prospective, observational study conducted over a period of one year. Patients deemed suitable for device closure underwent 2D and 3D TEE at baseline. Defect characteristics, assessed separately in both modalities, were compared. Using regression analysis, we aimed to derive an equation for predicting device size using 3D TEE parameters. RESULTS: Thirty patients were included in the study, majority being females (83%). The mean age of the study population was 40.5 ± 12.05 years. Chest pain, dyspnea and palpitations were the common presenting complaints. All patients had suitable rims on 2D TEE. A good agreement was noted between 2D and 3D TEE for measured ASD diameters. 3D TEE showed that majority of defects were circular in shape (60%). The final device size used had high degree of correlation with 3D defect area and circumference. An equation was devised to predict device size using 3D defect area and circumference. The mean device size obtained from the equation was similar to the actual device size used in the study population (p = 0.31). CONCLUSIONS: Device sizing based on 3D TEE parameters alone is equally effective for transcatheter ASD closure as compared to 2D TEE.

키워드

참고문헌

  1. Webb G, Gatzoulis MA. Atrial septal defects in the adult: recent progress and overview. Circulation 2006;114:1645-53.
  2. Humenberger M, Rosenhek R, Gabriel H, et al. Benefit of atrial septal defect closure in adults: impact of age. Eur Heart J 2011;32:553-60.
  3. Stout KK, Daniels C, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation 2019;139:e698-800.
  4. Carlson KM, Justino H, O'Brien RE, et al. Transcatheter atrial septal defect closure: modified balloon sizing technique to avoid overstretching the defect and oversizing the Amplatzer septal occluder. Catheter Cardiovasc Interv 2005;66:390-6.
  5. Harikrishnan S, Narayanan NK, Sivasubramonian S. Sizing balloon-induced tear of the atrial septum. J Invasive Cardiol 2005;17:546-7.
  6. Rana BS. Echocardiography guidance of atrial septal defect closure. J Thorac Dis 2018;10:S2899-908.
  7. Rana BS. Three-dimensional echocardiography and structural heart interventions. Br J Hosp Med (Lond) 2014;75:378-83.
  8. Mor-Avi V, Sugeng L, Lang RM. Real-time 3-dimensional echocardiography: an integral component of the routine echocardiographic examination in adult patients? Circulation 2009;119:314-29.
  9. Taniguchi M, Akagi T, Watanabe N, et al. Application of real-time three-dimensional transesophageal echocardiography using a matrix array probe for transcatheter closure of atrial septal defect. J Am Soc Echocardiogr 2009;22:1114-20.
  10. Jang JY, Heo R, Cho MS, et al. Efficacy of 3D transoesophageal echocardiography for transcatheter device closure of atrial septal defect without balloon sizing. Eur Heart J Cardiovasc Imaging 2018;19:684-9.
  11. Hascoet S, Hadeed K, Marchal P, et al. The relation between atrial septal defect shape, diameter, and area using three-dimensional transoesophageal echocardiography and balloon sizing during percutaneous closure in children. Eur Heart J Cardiovasc Imaging 2015;16:747-55.
  12. Seo JS, Song JM, Kim YH, et al. Effect of atrial septal defect shape evaluated using three-dimensional transesophageal echocardiography on size measurements for percutaneous closure. J Am Soc Echocardiogr 2012;25:1031-40.
  13. Gupta SK, Sivasankaran S, Bijulal S, Tharakan JM, Harikrishnan S, Ajit K. Trans-catheter closure of atrial septal defect: balloon sizing or no balloon sizing - single centre experience. Ann Pediatr Cardiol 2011;4:28-33.
  14. Roushdy A, El Sayegh A, Ali YA, Attia H, El Fiky A, El Sayed M. A novel three-dimensional echocardiographic method for device size selection in patients undergoing ASD trans-catheter closure. Egypt Heart J 2020;72:1.
  15. Amin Z, Hijazi ZM, Bass JL, Cheatham JP, Hellenbrand WE, Kleinman CS. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv 2004;63:496-502.