Transcatheter Closure of Atrial Septal Defects with Cardiac Computed Tomography Sizing: Eight-Year Single-Center Practice
Transcatheter Closure of Atrial Septal Defects with Cardiac Computed Tomography Sizing: Eight-Year Single-Center Practice
复制标题
使用心脏计算机断层扫描尺寸经导管封堵房间隔缺损：八年单中心实践
DOI：
10.1159/000508650
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发表时间：
2020-08
期刊：
影响因子：
1.9
通讯作者：
Tang Jun
中科院分区：
文献类型：
--
作者：
Zhang Xin;Huang Yangyang;Wang Lihong;Ye Lifang;Tang Jun
房间隔缺损（ASD）的准确评估对介入治疗的成功至关重要。尽管经食管超声心动图（TEE）仍然是公认的方法，但心脏计算机断层扫描（CT）在评估ASD方面具有独特的优势。目的：本研究旨在评价经导管封堵ASD的安全性和可行性，该方法采用心脏CT定影而不采用TEE测量。方法：134例经导管闭合患者中，13例行TEE +心脏CT检查，121例仅行心脏CT检查。倾向评分匹配用于分析接受TEE检查组（第一组）和未接受TEE检查组（第二组）的结果。记录分析121例仅行心脏CT扫描的ASD患者的成功率及并发症。将CT图像测得的缺损最大直径与超声心动图结果进行比较，并分别通过Student t检验和Pearson线性回归分析与器械尺寸的相关性。结果：1组和2组在成功率、并发症、心脏CT测量的器械尺寸与缺损最大直径之比方面无显著差异（p > 0.05）。在第一组中，心脏CT和TEE显示的ASD最大直径具有可比性（22.08±9.68 vs. 21.50±10.24;p = 0.351）。121例仅行心脏CT成像的经导管闭合患者的成功率为99.2%；但随访1个月内，2例患者出现心律失常，1例患者出现残留分流，1例患者出现感染，1例患者出现血肿，但均在短时间内康复。结论：心脏CT对ASD的评估与TEE具有可比性，仅根据CT大小进行ASD经导管闭合是安全可行的。
Introduction: An accurate evaluation of atrial septal defect (ASD) is important for the success of interventional treatment. Cardiac computed tomography (CT) has unique advantages for ASD assessment, although transesophageal echocardiography (TEE) remains the accepted method. Objective: This study aimed to evaluate the safety and feasibility of transcatheter closure of ASD with cardiac CT sizing but without TEE measurement. Methods: Among 134 patients undergoing transcatheter closure, 13 underwent TEE in addition to a cardiac CT examination, and 121 underwent only cardiac CT. Propensity score matching was used to analyze the outcomes of the groups treated with (group 1) or without (group 2) TEE examinations. The success rate and complications among the 121 ASD patients with only cardiac CT sizing were recorded and analyzed. The maximal diameters of the defects remeasured on CT images were compared to the echocardiography results and correlated with the device size by Student t test and Pearson’s linear regression analysis, respectively. Results: No significant differences (p > 0.05) were found between groups 1 and 2 in the success rate, complications, or ratio of the device size to the maximum diameter of the defect measured by cardiac CT. In group 1, the maximum diameters of the ASD derived from cardiac CT and TEE were comparable (22.08 ± 9.68 vs. 21.50 ± 10.24; p = 0.351). The success rate among the 121 patients who underwent transcatheter closure with only cardiac CT sizing was 99.2%; however, within 1 month of follow-up, 2 patients had arrhythmia, 1 patient had residual shunting, 1 patient had an infection, and 1 patient had a hematoma, but all patients recovered within a short time. Conclusions: Cardiac CT seems to be comparable to TEE in the assessment of ASD, and transcatheter closure of ASD based on CT sizing alone is safe and feasible.
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影响因子：
5
作者：
Ko, Sheung-Fat;Liang, Chi-Di;Chen, Min-Chi
通讯作者：
Chen, Min-Chi
影响因子：
168.9
作者：
Geva, Tal;Martins, Jose D.;Wald, Rachel M.
通讯作者：
Wald, Rachel M.
DOI：
10.1007/978-3-319-42919-9_2
发表时间：
1961
期刊：
Proceedings of the Royal Society of Medicine
影响因子：
--
作者：
Paul Evans
通讯作者：
Paul Evans
影响因子：
5.4
作者：
S. Shoji;H. Kanazawa;Yoshitake Yamada;M. Jinzaki;K. Fukuda
通讯作者：
S. Shoji;H. Kanazawa;Yoshitake Yamada;M. Jinzaki;K. Fukuda
影响因子：
5.9
作者：
Y. Yamasaki;M. Nagao;S. Kawanami;T. Kamitani;Koji Sagiyama;T. Yamanouchi;I. Sakamoto;Kenichiro Yamamura;H. Yabuuchi;H. Honda
通讯作者：
Y. Yamasaki;M. Nagao;S. Kawanami;T. Kamitani;Koji Sagiyama;T. Yamanouchi;I. Sakamoto;Kenichiro Yamamura;H. Yabuuchi;H. Honda