Safety and Efficacy of Transcatheter Closure of Atrial Septal Defects Guided by Transthoracic Echocardiography: A Prospective Study From Two Chinese Medical Centers

Transthoracic echocardiography is a safe alternative for assessment and guidance of transcatheter closure of secundum atrial septal defect in children

“…Our main finding is that in experienced hands, 2D-TTE associated with balloon-sizing is a valuable alternative to 2D-TEE for ASD closure guidance. Our results are in accordance to other groups (30,31). TTE-guidance is not universally accepted and published data are limited to either small series or selected patients (10)(11)(12).…”

“…However the rational to consider TTE guidance as an alternative is driven by some rare reports of TEE-related esophageal perforation in adults and children (6)(7)(8), as well as the fact that TTE-guidance may allow to shorten both procedure time and fluoroscopy time (30) and to avoid general anesthesia and orotracheal intubation in spontaneously breathing children (30,31). Additionally, one can present the argument that in TTEguided procedures, the interventionist may be able to complete the whole process himself without the need for an additional echographist and without additional irradiation (10,30).…”

Safety and feasibility of intra-operative device closure of atrial septal defect with transthoracic minimal invasion

“…They were then placed in a supine position and draped to expose the entire chest, with the right hemithorax elevated approximately 30°. Intra-operative TTE was used to assess the ASD; in particular, the defect size and circumferential margins adjacent to the superior and inferior vena cava, pulmonary vein, mitral valve, and aortic sinus [10]. The atrial septal occluder was chosen according to the largest diameter of the ASD, allowed for a margin of 2-6 mm in excess of the diameter.…”

Transcatheter atrial septal defect closure guided by colour flow Doppler

“…Transoesophageal (TOE) or transthoracic echocardiography (TTE) have also been used to guide device implantation without balloon sizing [14][15][16]. Limitations of these methods have been noted for patients with large defects [15,16], or floppy and thin rims, atrial septal aneurysms and fenestrated defects [14][15][16].…”

“…Limitations of these methods have been noted for patients with large defects [15,16], or floppy and thin rims, atrial septal aneurysms and fenestrated defects [14][15][16].…”