Intracardiac echocardiography for percutaneous closure of atrial septal defects: initial experiences in Japan
Intracardiac echocardiography for percutaneous closure of atrial septal defects: initial experiences in Japan
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DOI：
10.1007/s12928-013-0187-7
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发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Fukuda, Keiichi
中科院分区：
文献类型：
--
作者：
Shimizu, Sayaka;Kawamura, Akio;Fukuda, Keiichi
经导管封堵继发孔房间隔缺损 (ASD) 作为一种侵入性较小的手术替代方案已得到广泛应用，迄今为止在日本死亡率为零。在美国和欧洲，心内超声心动图 (ICE) 已取代经食管超声心动图 (TEE)，成为经皮 ASD 封堵期间的主要成像工具。然而，ICE 在 ASD 封堵方面的经验在日本有限。连续 51 名患者在 ICE 指导下接受经皮 ASD 封堵术。将临床结果与 41 名在 TEE 指导下接受 ASD 封堵术的患者的临床结果进行了比较。预计需要多个设备的儿科患者和患有多种 ASD 的患者被排除在外。两组的成功率相似（ICE 96.1 %，TEE 92.7 %）。 ICE 的导管插入实验室时间比 TEE 显着缩短（131 分钟 vs. 155 分钟，p = 0.0003）。没有出现与使用 ICE 相关的并发症。 ICE 引导的 ASD 封堵术对于大多数成年患者来说是可行的。 ICE 在缩短导管实验室时间和消除全身麻醉方面优于 TEE，并且有可能取代 TEE 作为经皮 ASD 封堵期间的主要图像引导。
Transcatheter closure of secundum atrial septal defect (ASD) has been widely performed as a less invasive alternative to surgery with zero mortality so far in Japan. In the US and Europe, intracardiac echocardiography (ICE) has replaced transesophageal echocardiography (TEE) as a primary imaging tool during percutaneous ASD closure. However, the experience of ICE in ASD closure is limited in Japan. Consecutive 51 patients underwent percutaneous ASD closure with ICE guidance. Clinical results were compared to those of 41 patients who underwent ASD closure with TEE guidance. Pediatric patients and patients with multiple ASDs who were expected to need multiple devices were excluded. Success rate was similar in both groups (ICE 96.1 %, TEE 92.7 %). Catheterization laboratory time was significantly shortened with ICE than with TEE (131 vs. 155 min, p = 0.0003). There were no complications related to the use of ICE. ICE-guided ASD closure is feasible in most adult patients. ICE is superior to TEE in shortening catheterization laboratory time and eliminating general anesthesia, and can potentially replace TEE as the primary image guide during percutaneous ASD closure.