Interatrial defect sizing by intracardiac and transesophageal echocardiography compared with fluoroscopic measurements in patients undergoing percutaneous transcatheter closure

Abstract

The purpose of this study was to evaluate prospectively the feasibility and accuracy of using echocardiographic measurements by transesophageal and intracardiac echocardiography (TEE and ICE, respectively) for interatrial septal defect sizing during percutaneous transcatheter closure. Forty-two patients underwent balloon sizing of interatrial septal defects using TEE in 21 of them and ICE in the other half. These measurements were correlated with quantitative fluoroscopic analysis and evaluated for bias and agreement between methods using a Bland-Altman analysis. Echocardiographic measurements were obtained by ICE and TEE in all patients. An excellent correlation was found between TEE and quantitative fluoroscopy (r = 0.898; P < 0.001) and between ICE and quantitative fluoroscopy (r = 0.876; P < 0.001), with a significant agreement (P < 0.001) and minimal positive bias toward the echocardiographic measurements. Both TEE and ICE are excellent methods of interatrial defect sizing when compared with quantitative fluoroscopic measurements.

Ice-Assisted Transcatheter Closure of Interatrial Shunts: Ten-Year Follow-Up

“…[20][21] ICE has been demonstrated to provide a higher accuracy than TOE in anatomical measurements and implantation guidance, [22][23] shortening catheterisation and interventional procedure time with no difference in rate of closure. Moreover, ICE has been suggested as the optimal imaging technique for anatomical morphological measurements and sizing the defect, decreasing the radiation exposure dose [24][25] findings, which were all confirmed in our study.…”

A biodegradable device (BioSTAR™) for atrial septal defect closure in children

“…2). The device diameter implanted was based upon the balloon stretched diameter (development of a waist or stop-flow technique [19,20]) measured from cinefluoroscopy and ICE, to be between 1.8 and 2 times the balloon diameter (Fig. 3).…”

O papel da ecocardiografia no tratamento percutâneo dos defeitos septais

“…Recent studies have shown that all measurements obtained on ICE have excellent correlation with those obtained by TEE, with better demonstration of guidewires, catheters and device discs 21,22 . Due to such advantages, ICE monitoring of percutaneous occlusion of ASD and PFO has become the standard of care for adolescents and adults in North America and Europe.…”