Percutaneous transcatheter closure of atrial septal defect guided by transthoracic echocardiography in outpatients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DENG Rundi , ZHANG Fengwen , XIE Yongquan , OUYANG Wenbin , LIU Yao , ZOU Mengxuan , WEN Bin , ZHANG Gejun , YAN Chaowu ,  PAN Xiangbin

National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P.R.China;

Corresponding author：

PAN Xiangbin, Email: panxiangbin@fuwaihospital.org

Keywords：

Atrial septal defect; echocardiography; transthoracic approach; outpatients

DOI：

10.7507/1007-4848.201911049

Video：

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Objective To assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect (ASD) guided by transthoracic echocardiography (TTE) in outpatients.Methods From December 2016 to June 2018, 50 simple ASD patients underwent TTE-guided transcatheter closure in the outpatient operating room of our hospital (a TTE group) including 22 males and 28 females at the age of 16-48 (27.40±6.95) years. Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group, including 22 males and 28 females at the age of 15-48 (28.58±6.96) years. Both groups were re-examined by TTE during follow-up at 1 month, 3 months, 6 months and 1 year.Results The mean age, body weight, the size of ASD and occluder and success rate had no statistical difference between the two groups (P>0.05). Compared with the control group, the TTE group had significantly lower mean operation time (P<0.01) and less cost (P<0.01) since patients need not to be hospitalized. No related complications were found in the TTE group during follow-up.Conclusion Percutaneous transcatheter closure of ASD guided by TTE appears safe and effective for outpatients, and can significantly reduce the cost.

Citation： DENG Rundi, ZHANG Fengwen, XIE Yongquan, OUYANG Wenbin, LIU Yao, ZOU Mengxuan, WEN Bin, ZHANG Gejun, YAN Chaowu, PAN Xiangbin. Percutaneous transcatheter closure of atrial septal defect guided by transthoracic echocardiography in outpatients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(1): 10-13. doi: 10.7507/1007-4848.201911049 Copy

1.	Moore J, Hegde S, El-Said H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv, 2013, 6(5): 433-442.
2.	Baruteau AE, Petit J, Lambert V, et al. Transcatheter closure of large atrial septal defects: feasibility and safety in a large adult and pediatric population. Circ Cardiovasc Interv, 2014, 7(6): 837-843.
3.	Mesihovic-Dinarevic S, Begic Z, Halimic M, et al. The reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect. Acta Med Acad, 2012, 41(2): 145-153.
4.	Kleinman CS. Echocardiographic guidance of catheter-based treatments of atrial septal defect: transesophageal echocardiography remains the gold standard. Pediatr Cardiol, 2005, 26(2): 128-134.
5.	欧阳文斌, 潘湘斌, 逄坤静, 等. 单纯食管超声引导经皮封堵治疗房间隔缺损. 中华实用儿科临床杂志, 2014, 29(18): 1425-1427.
6.	Liu Y, Guo GL, Ouyang WB, et al. Feasibility and effectiveness of percutaneous ventricular septal defect closure under solely guidance of echocardiography. Zhonghua Yi Xue Za Zhi, 2017, 97(16): 1222-1226.
7.	周爱卿, 蒋世良. 先天性心脏病经导管介入治疗指南. 中华儿科杂志, 2004, 42(3): 234-239.
8.	Boutin C, Musewe NN, Smallhorn JF, et al. Echocardiographic follow-up of atrial septal defect after catheter closure by double-umbrella device. Circulation, 1993, 88(2): 621-627.
9.	King TD, Thompson SL, Steiner C, et al. Secundum atrial septal defect. Nonoperative closure during cardiac catheterization. JAMA, 1976, 235(23): 2506-2509.
10.	Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.
11.	潘湘斌, 逄坤静, 欧阳文斌, 等. 单纯超声心动图引导下经皮室间隔缺损封堵术的应用研究. 中国循环杂志, 2015, 30(8): 774-776.
12.	欧阳文斌, 张凤文, 郭改丽, 等. 单纯超声引导下经皮诱导血栓形成术治疗细小动脉导管未闭. 中华实用儿科临床杂志, 2017, 32(13): 990-992.
13.	张玉琴, 王丽荣. 耳鼻喉科门诊有创性治疗的护理干预. 河北联合大学学报(医学版), 2010, 12(1): 87-88.
14.	Karl A, Blasl H, Straub J, et al. Pediatric outpatient surgery. Der Urologe Ausg A, 2016, 55(1): 19-26.
15.	Gentry Iii JL, Phelan D, Desai MY, et al. The role of stress echocardiography in valvular heart disease: a current appraisal. Cardiology, 2017, 137(3): 137-150.
16.	潘湘斌, 逄坤静, 胡盛寿, 等. 经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性. 中华心血管病杂志, 2013, 41(9): 744-746.
17.	Munnich EL, Parente ST. Returns to specialization: Evidence from the outpatient surgery market. J Health Econ, 2018, 57: 147-167.

1. Moore J, Hegde S, El-Said H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv, 2013, 6(5): 433-442.
2. Baruteau AE, Petit J, Lambert V, et al. Transcatheter closure of large atrial septal defects: feasibility and safety in a large adult and pediatric population. Circ Cardiovasc Interv, 2014, 7(6): 837-843.
3. Mesihovic-Dinarevic S, Begic Z, Halimic M, et al. The reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect. Acta Med Acad, 2012, 41(2): 145-153.
4. Kleinman CS. Echocardiographic guidance of catheter-based treatments of atrial septal defect: transesophageal echocardiography remains the gold standard. Pediatr Cardiol, 2005, 26(2): 128-134.
5. 欧阳文斌, 潘湘斌, 逄坤静, 等. 单纯食管超声引导经皮封堵治疗房间隔缺损. 中华实用儿科临床杂志, 2014, 29(18): 1425-1427.
6. Liu Y, Guo GL, Ouyang WB, et al. Feasibility and effectiveness of percutaneous ventricular septal defect closure under solely guidance of echocardiography. Zhonghua Yi Xue Za Zhi, 2017, 97(16): 1222-1226.
7. 周爱卿, 蒋世良. 先天性心脏病经导管介入治疗指南. 中华儿科杂志, 2004, 42(3): 234-239.
8. Boutin C, Musewe NN, Smallhorn JF, et al. Echocardiographic follow-up of atrial septal defect after catheter closure by double-umbrella device. Circulation, 1993, 88(2): 621-627.
9. King TD, Thompson SL, Steiner C, et al. Secundum atrial septal defect. Nonoperative closure during cardiac catheterization. JAMA, 1976, 235(23): 2506-2509.
10. Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.
11. 潘湘斌, 逄坤静, 欧阳文斌, 等. 单纯超声心动图引导下经皮室间隔缺损封堵术的应用研究. 中国循环杂志, 2015, 30(8): 774-776.
12. 欧阳文斌, 张凤文, 郭改丽, 等. 单纯超声引导下经皮诱导血栓形成术治疗细小动脉导管未闭. 中华实用儿科临床杂志, 2017, 32(13): 990-992.
13. 张玉琴, 王丽荣. 耳鼻喉科门诊有创性治疗的护理干预. 河北联合大学学报(医学版), 2010, 12(1): 87-88.
14. Karl A, Blasl H, Straub J, et al. Pediatric outpatient surgery. Der Urologe Ausg A, 2016, 55(1): 19-26.
15. Gentry Iii JL, Phelan D, Desai MY, et al. The role of stress echocardiography in valvular heart disease: a current appraisal. Cardiology, 2017, 137(3): 137-150.
16. 潘湘斌, 逄坤静, 胡盛寿, 等. 经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性. 中华心血管病杂志, 2013, 41(9): 744-746.
17. Munnich EL, Parente ST. Returns to specialization: Evidence from the outpatient surgery market. J Health Econ, 2018, 57: 147-167.

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