Copyright © 2005, The European Society of Cardiology
Intracardiac echocardiography: an ideal guiding tool for device closure of interatrial communications
aCardiology Division, West-German Heart Center, University Clinic Essen, Hufelandstrasse 55, 45122 Essen, Germany
bCardiology Division, Department of Paediatrics, University Duisburg, Essen, Germany
Received 12 December 2003; received in revised form 22 July 2004; accepted after revision 27 July 2004.
* Corresponding author. Tel.: +49 201 723 4805; fax: +49 201 723 5401. thomas.bartel{at}uni-essen.de
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Abstract |
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Background This study sought to evaluate safety and radiation exposure when using intracardiac echocardiography (ICE) in comparison to transesophageal echocardiography (TEE) in order to guide transcatheter closure of interatrial communications.
Methods Eighty patients (44 males, 36 females, mean age 46, SD 13 years) undergoing device closure of atrial septal defect (n=12) or patent foramen ovale (n=68) had the procedure guided by ICE (n=50, group 1) or TEE (n=30, group 2). In group 1, all procedural stages were completely guided by ICE, including imaging of the interatrial communication during balloon sizing, device unfolding and release, and during the final check for adequate positioning. In group 2, exclusive implantation of devices was guided by use of TEE.
Results Especially, the spatial relationship between device and cardiac structures (e.g. the ascending aorta, the interatrial septum and the superior vena cava) was accurately demonstrated in group 1. Image resolution provided by ICE was superior to that of TEE. No severe complications, including any related to ICE, were seen. Fluoroscopy time (FT) and procedure time (PT) were shorter in group 1 than in group 2 (FT: 5.5±1.5min vs. 9.3±1.6min, P<0.0001; PT: 31.9±4.6min vs. 38.8±5.8min, P<0.01). Neither sedation nor anesthesia was required in group 1.
Conclusions ICE is a safe tool to guide device closure of interatrial communications. For the patient, procedural stress and radiation exposure are negligible. ICE can be considered the guiding tool of choice for device closure, particularly when long or repeated echocardiographic viewing is required.
Keywords: Intracardiac echo; Interatrial communications; Device closure
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