Transcatheter Atrial Septal Defect Closure in Children with and without Fluoroscopy: A Comparison.
Child
Child, Preschool
Echocardiography, Transesophageal
/ methods
Feasibility Studies
Female
Fluoroscopy
/ methods
Heart Septal Defects, Atrial
/ diagnostic imaging
Humans
Male
Outcome and Process Assessment, Health Care
Prosthesis Implantation
/ adverse effects
Retrospective Studies
Septal Occluder Device
Surgery, Computer-Assisted
/ methods
Switzerland
/ epidemiology
Journal
Journal of interventional cardiology
ISSN: 1540-8183
Titre abrégé: J Interv Cardiol
Pays: United States
ID NLM: 8907826
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
11
2018
revised:
30
01
2019
accepted:
04
03
2019
entrez:
28
11
2019
pubmed:
28
11
2019
medline:
29
2
2020
Statut:
epublish
Résumé
The aim of this study was to compare feasibility, effectiveness, safety, and outcome of atrial septal defect (ASD) device closure in children with and without fluoroscopy guidance. Children undergoing transcatheter ASD closure between 2002 and 2016 were included into this single center, retrospective study. Patients were analysed in two groups [1: intraprocedural fluoroscopy ± transoesophageal echocardiography (TOE) guidance; 2: TOE guidance alone]. Three-hundred-ninety-seven children were included, 238 (97 male) in group 1 and 159 (56 male) in group 2. Two-hundred-twenty-nine of 238 (96%) patients underwent successful fluoroscopy guided ASD closures versus 154/159 (97%) successful procedures with TOE guidance alone. Median weight (IQR) at intervention was 20kg (16.0-35.0) in group 1 versus 19.3kg (16.0-31.2) in group 2. Mean (SD) preinterventional ASD diameter was 12.4mm (4.4) in group 1 versus 12.2mm (3.9) in group 2. There was no significant difference in number of defects or characteristics of ASD rims. Median procedure time was shorter in group 2 [60min (47-86) versus 34min (28-44)]. Device-size-to-defect-ratio was similar in both groups [group 1: 1.07 versus group 2: 1.09]. There were less technical intraprocedural events in group 2 [10 (6.3%) versus 47 (20%)]. Intraprocedural complications were less frequent in group 2 [1 (0.6%) versus 8 (3.3%)]. Transcatheter ASD device closure with TOE guidance alone (i.e., without fluoroscopy) is as effective and safe as ASD closure with fluoroscopy guidance. As fluoroscopy remains an important adjunct to transoesophageal echocardiography, especially in complex defects and complications, procedures are always performed in a fully equipped cardiac catheterization laboratory.
Identifiants
pubmed: 31772540
doi: 10.1155/2019/6598637
pmc: PMC6739773
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
6598637Informations de copyright
Copyright © 2019 S. Ackermann et al.
Déclaration de conflit d'intérêts
There are no conflicts of interest to declare.
Références
EuroIntervention. 2016 Aug 05;12(5):e652-7
pubmed: 27497366
Pediatr Cardiol. 2015 Jan;36(1):190-5
pubmed: 25096904
Radiat Prot Dosimetry. 2015 Jul;165(1-4):13-6
pubmed: 25833897
Heart. 2017 Mar;103(5):341-346
pubmed: 27540181
Pediatr Cardiol. 2009 Apr;30(3):240-7
pubmed: 19015911
Pediatr Cardiol. 2018 Mar;39(3):445-449
pubmed: 29138879
J Am Coll Cardiol. 1983 Jul;2(1):127-35
pubmed: 6853907
Catheter Cardiovasc Interv. 2018 Mar 1;91(4):647-654
pubmed: 28707381
J Am Soc Echocardiogr. 2008 Aug;21(8):922-34
pubmed: 18406572
Catheter Cardiovasc Interv. 2012 Feb 1;79(2):302
pubmed: 22271557
Eur J Radiol. 2012 Nov;81(11):3563-7
pubmed: 21820256
Circulation. 2000 Feb 29;101(8):847-9
pubmed: 10694522
Am J Cardiol. 1978 Mar;41(3):537-42
pubmed: 626130
JACC Cardiovasc Interv. 2015 Apr 20;8(4):616-27
pubmed: 25907089
JACC Cardiovasc Imaging. 2017 Jul;10(7):797-818
pubmed: 28514670
J Am Coll Cardiol. 1985 Jul;6(1):49-54
pubmed: 4008787
J Interv Cardiol. 2016 Dec;29(6):646-653
pubmed: 27625018
Clin Res Cardiol. 2012 Sep;101(9):691-700
pubmed: 22454137
J Interv Cardiol. 2002 Aug;15(4):287-92
pubmed: 12238424
Int J Cardiol. 2014 Feb 15;171(3):461-3
pubmed: 24439857
Catheter Cardiovasc Interv. 2005 Nov;66(3):390-6
pubmed: 16142805
J Am Coll Cardiol. 2011 Nov 15;58(21):2241-7
pubmed: 22078432
Cardiol Young. 1999 Mar;9(2):136-40
pubmed: 10323510
Eur Heart J. 2010 Dec;31(23):2915-57
pubmed: 20801927
Circulation. 2016 Jan 5;133(1):12-20
pubmed: 26538581
Med Instrum. 1978 Jan-Feb;12(1):65-9
pubmed: 634194
Int J Cardiol Heart Vasc. 2015 Jan 20;6:101-109
pubmed: 28785634
J Am Coll Cardiol. 2008 Dec 2;52(23):e143-e263
pubmed: 19038677
Int J Cardiol. 2010 Sep 3;143(3):373-7
pubmed: 19368981
Clin Med Insights Cardiol. 2015 Mar 23;8(Suppl 1):93-8
pubmed: 25861226
J Pediatr. 2017 Nov;190:261-264.e1
pubmed: 28918881
Pediatr Int. 2015 Aug;57(4):535-40
pubmed: 25523547
Int J Cardiol. 2006 Nov 10;113(2):283-4
pubmed: 16330116