Percutaneous Closure of Atrial Septal Defects Under Transthoracic Echocardiography Guidance Without Fluoroscopy or Intubation in Children

Pan, Xiangbin; Ouyang, Wenbin; Pang, Kunjing; Zhang, Feng-Wen; Wang, Shouzheng; Liu, Yao; Zhang, Dawei; Guo, Guangran; Tian, Pengsheng; Hu, Shengshou

doi:10.1111/joic.12214

Cited by 39 publications

(48 citation statements)

References 13 publications

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“…We posited that the latter echocardiography guidance option also should be encouraged for all patients to avoid the detrimental radiation exposure of both doctors and patients, reduce cost, and allow adaptation to an outpatient procedure. Percutaneous And Non‐fluoroscopic procedure (PAN procedure) for atrial septal defect (ASD), patent ductus arteriosus (PDA), pulmonary stenosis(PS), and ventricular septal defect(VSD) are routinely performed at our center using echocardiography as the only imaging tool . Early experiences of echo‐guided percutaneous treatments helped us to successfully perform nonfluoroscopy‐guided PBMV.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous And Non-fluoroscopic procedure (PAN procedure) for atrial septal defect (ASD), patent ductus arteriosus (PDA), pulmonary stenosis(PS), and ventricular septal defect(VSD) are routinely performed at our center using echocardiography as the only imaging tool. [13][14][15][16] Early experiences of echo-guided percutaneous treatments helped us to successfully perform nonfluoroscopyguided PBMV.…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and effectiveness of percutaneous balloon mitral valvuloplasty under echocardiographic guidance only

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility and effectiveness of percutaneous balloon mitral valvuloplasty under echocardiographic guidance only

et al. 2018

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“…Percutaneous PDA occlusion was first described more than three decades ago and has become the procedure of choice. In recent years, with the extensive use of echocardiography for patient selection and guidance during intervention procedures, echocardiography has become an important tool to improve percutaneous interventional procedures . With increasing operator experience and the development of devices, x‐ray exposure and contrast agents use are minimized largely.…”

Section: Discussionmentioning

confidence: 99%

“…As Ewert et al reported transcatheter closure of atrial septal defects under transesophageal echocardiography without fluoroscopy in 2000, many centers explored to perform transcatheter procedures without fluoroscopy, few succeed. We have reported percutaneous closure of atrial septal defects under transthoracic echocardiographic guidance in 60 patients with satisfactory outcomes . Recently, transthoracic echocardiography (TTE) was used during transcatheter occlusion of PDA to reduce potential injury related to fluoroscopy and angiography .…”

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Transthoracic Echocardiography‐Guided Percutaneous Patent Ductus Arteriosus Occlusion: A New Strategy for Interventional Treatment

et al. 2016

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“…Pan et al have admirably performed percutaneous closure of atrial septal defects (ASD) under transthoracic echocardiography (TTE) guidance without fluoroscopy or intubation in children. Their work is commendable considering the high success rate even with TTE.…”

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Letter to the Editor and Response: Percutaneous Closure of Atrial Septal Defects Under Transthoracic Echocardiography Without Fluoroscopy

Krishnamoorthy

Sasikumar

Sasidharan

2016

J Interven Cardiology

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Dear Editor,Pan et al. 1 have admirably performed percutaneous closure of atrial septal defects (ASD) under transthoracic echocardiography (TTE) guidance without fluoroscopy or intubation in children. Their work is commendable considering the high success rate even with TTE. They showed significant reduction in procedure time as well as cost of the procedure when transoesophageal echocardiography (TEE) was avoided.However, we have a few concerns that we request to be clarified. (a) The distance defined as the "working length" for catheter insertion could be a matter of conjecture. This is the in vitro distance form right parasternal third intercostal space to puncture site. It is then applied in vivo to catheters, wires and sheaths such that nothing is inserted 5 cm longer than the "working length." It is a straight line measurement of the distance between the right third intercostal space to the puncture site. This corresponds to the distance travelled by hardwares from groin to right atrium through the inferior vena cava. These points do not actually lie in a straight line in vivo. Hence, the in vitro measurement could be flawed and not correspond to in vivo length. (b) Because of this subjectivity, there is a risk of injury to cardiac structures especially in the small hearts of children. Even a difference of a millimeter between measured in vitro and actual in vivo distance can be dangerous. Hence, there is apprehension about the small margin of safety. (c) Directing the catheter tip into the left upper pulmonary vein appeared to be risky when we tried to reproduce this method. This movement was blind and could not be clearly visualized by TTE. (d) We would also like to know the criteria adopted to separate the groups who had device closure under TTE or TEE. (e) It may also be clarified whether their method was applied only to small ASD (mean size is 11-12 mm).In previous attempts at device closure with echocardiographic guidance alone, 2 a balloon tipped catheter was passed into the left atrium. The distance from catheter tip to the groin was estimated to be the distance of the delivery sheath to be passed into left atrium. We feel that this method suffers from the same problem of assumption of approximate length, could be hazardous, especially in children. References 1. Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol 2015;28:390-395. 2. Schubert S, Kainz S, Peters B, et al. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol 2012;101:691-700. Response:We appreciate the interest in our work about atrial septal defect (ASD) closure under only guidance of transthoracic echocardiography (TTE) without fluoroscopy.

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Percutaneous Closure of Atrial Septal Defects Under Transthoracic Echocardiography Guidance Without Fluoroscopy or Intubation in Children

Abstract: Percutaneous ASD closure with TTE guidance as the only imaging tool avoids fluoroscopy, endotracheal intubation, and probe insertion and is associated with a satisfactory procedural success rate and lower costs. This procedure is a safe and reliable treatment for ASD.

Cited by 39 publications

References 13 publications

Feasibility and effectiveness of percutaneous balloon mitral valvuloplasty under echocardiographic guidance only

Feasibility and effectiveness of percutaneous balloon mitral valvuloplasty under echocardiographic guidance only

Transthoracic Echocardiography‐Guided Percutaneous Patent Ductus Arteriosus Occlusion: A New Strategy for Interventional Treatment

Letter to the Editor and Response: Percutaneous Closure of Atrial Septal Defects Under Transthoracic Echocardiography Without Fluoroscopy

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