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Transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim under echocardiography only: a feasibility and safety analysis

Part of: Interventional Cardiology

Published online by Cambridge University Press:  12 July 2021

Liu Liu Huang Open the ORCID record for Liu Liu Huang [Opens in a new window] ,
Ji Wu ,
Mai Chen ,
Chun Lan Jiang ,
De C. Zeng ,
Chun Xiao Su  and
Bao Shi Zheng
Liu Liu Huang
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Ji Wu*
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Mai Chen
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Chun Lan Jiang
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
De C. Zeng
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Chun Xiao Su
Affiliation:
Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
Bao Shi Zheng
Affiliation:
Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
*
Author for correspondence: Ji Wu, Department of Ultrasound, First Affiliated Hospital of Guangxi Medical University, No 6 ShuangYong Road Nanning, Guangxi530021, China. Tel: 15507882109. E-mail: gxnnwuji@126.com
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Abstract

Background:

The safe closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim is a controversial issue. Few studies have been conducted on the closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim without fluoroscopy. This study evaluated the feasibility and safety of echocardiography-guided transcatheter closure of atrial septal defect with deficient posterior-inferior or inferior vena cava rim.

Methods:

The data of 136 patients who underwent transcatheter atrial septal defect closure without fluoroscopy from March 2017 to March 2020 were retrospectively analysed. The patients were classified into the deficient (n = 45) and sufficient (n = 91) posterior-inferior or inferior vena cava rim groups. Procedure and the follow-up results were compared between the two groups.

Results:

Atrial septal defect indexed diameter and the device indexed diameter in the deficient rim group were both larger than that in the sufficient rim group (22.12 versus 17.38 mm/m2, p < 0.001; 24.77 versus 21.21 mm/m2, p = 0.003, respectively). There was no significant difference in the success rate of occlusion between two groups (97.78% in the deficient rim group versus 98.90% in the sufficient rim group, p = 1.000). During follow-up, the incidence of severe adverse cardiac events was not statistically significant (p = 0.551).

Conclusions:

Atrial septal defect with deficient posterior-inferior or inferior vena cava rim can safely undergo transcatheter closure under echocardiography alone if precisely evaluated with transesophageal or transthoracic echocardiography and the size of the occluder is appropriate. The mid-term results after closure are similar to that for an atrial septal defect with sufficient rim.

Keywords

Transcatheter closureatrial septal defectwithout fluoroscopy
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 589 - 596
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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