Objective:This study aimed to assess the safety and feasibility of transcatheter device closure of atrial septal defects (ASDs) guided completely by transthoracic echocardiography (TTE).Methods:A total of 152 patients underwent transcatheter device closure of ASDs guided completely by TTE in our center from September 2014 to June 2017. We used routine delivery sheaths during the procedure and then closed the ASDs by releasing a domestic occluder.Results:The closure was successful in 150 patients, and surgical repair was required in two patients. The size of the deployed occluder ranged from 10 mm to 38 mm (21.4±8.5 mm), and the procedure duration ranged from 30 to 90 min (38.2±21.4 min). No fatal complications were observed. Minor complications included transient arrhythmias (n=12) during the process of device deployment. The follow-up period was 3 months to 2 years, with no occluder dislodgment, residual fistula, or thrombus-related complications. In our comparative studies, no statistically significant differences were observed in success rates and complications.Conclusion:Transcatheter device closure of ASDs guided completely by TTE may be safe and effective and can be an alternative to traditional methods.

eft atrial function is of great importance in the normal heart as well as in the diseased heart, and its significant contribution to ventricular filling has been already discussed. [1][2][3][4][5][6][7] The left atrium (LA) serves not only as a reservoir for the collection and storage of blood during left ventricular systole but also as a contractile pump to augment late left ventricular filling. 8 Thus the evaluation of LA function as well as left ventricular function in diseased hearts is very useful for clinical decision-making particularly in the presence of heart failure.For the noninvasive assessment of LA function, echocardiography has been used to calculate the LA volume with a manual tracing procedure. 2-6 However, real-time determination of LA volume may be more useful in clinical settings. Although echocardiography with the automatic boundary detection (ABD) technique enables measurement of the blood area within a region of interest and provides a noninvasive and real-time continuous cyclic volume change of the left ventricle 9-13 or LA, 14-17 few data exist regarding the accuracy of this technique for the determination of LA volume. Therefore, using ABD we attempted to validate the LA volume changes in comparison with the manual tracing method using the modified Simpson's method on frozen frames from an apical four-chamber view. Methods Study PatientsA total of 59 patients with coronary heart disease that had been documented by coronary angiography and left ventriculography entered the present study. These patients were selected from 89 patients according to the following criteria: (1) more than 75% of the LA cavity and wall were adequately visualized from the apical four-chamber view; (2) with the proper machine settings the LA volume curve by ABD was obtained; and (3) normal sinus rhythm was present.There were 54 men and 5 women, mean age of 60±8 years (range, 37-77 years), including 30 patients with angina pectoris, 13 with recent myocardial infarction and 16 patients with old myocardial infarction. None had evidence of mitral stenosis. Based on color flow images, mild or moderate mitral regurgitation was present in 23 patients. Echocardiographic ExaminationWe used an echocardiographic system (Sonos 2500, Hewlett-Packard) with an ultrasound transducer operating at 2.5 MHz. All subjects were studied in the left lateral recumbent position, and the patients were asked to avoid Comparison of Automatic Boundary Detection and Manual Tracing Technique in Echocardiographic Determination of Left Atrial VolumeJpn Circ J 1998; 62: 755 -759 Gui Can Zhang, MD; Takanori Tsukada, BS*; Satoshi Nakatani, MD; Masaaki Uematsu, MD; Yoshio Yasumura, MD; Norio Tanaka, BS*; Yoshikazu Masuda, BS*; Kunio Miyatake, MD; Masakazu Yamagishi, MD Previous reports have indicated that echocardiography with automatic boundary detection (ABD) is useful for the noninvasive estimation of left ventricular volume. However, few data exist regarding the measurement of left atrial (LA) volume, which also provides pivotal information in...

Objective:We aimed to investigate the feasibility and safety of stand-alone transthoracic echocardiography-guided percutaneous occlusion of patent ductus arteriosus (PDA) without the use of X-ray equipment.Methods:From January to December 2015, we performed stand-alone transthoracic echocardiography-guided percutaneous PDA occlusion using an occluder delivered via a delivery sheath introduced via femoral vein access without the use of X-ray equipment in 12 PDA patients.Results:PDA occlusion was successfully performed in all 12 patients. The procedure duration ranged from 30 to 110 min (50.4±22.8 min), and the size of the implanted occluder ranged from 12 to 20 mm (15.2±2.8 mm). No occluder migration, residual shunt, or thrombotic complications were observed in the perioperative period. There was no clinical death, hemolysis, infection, or embolism during patients’ hospitalization and the follow-up period.Conclusion:Stand-alone transthoracic echocardiography-guided percutaneous PDA occlusion without the use of X-ray equipment is a safe and effective procedure.