Evaluation of the effectiveness of transcatheter closure of fenestrated atrial septal defect via femoral vein under ultrasound guidance_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUN Bao ¹ ,  CHENG Duan ¹ , LI Bo ² , HE Guibao ¹ , WANG Haifeng ¹ , Ahati ¹ , Elias ¹ , SHENG Xi ¹ , LI Jinpeng ¹ , Saddam Hussein ¹ , YU Guojun ¹ , ZHAN Shusheng ² , ZHANG Ling ²

1. Department of Cardiac Surgery, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;
2. Department of Ultrasound, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;

Corresponding?author：

CHENG Duan, Email: chengduan@126.com

Keywords：

Echocardiography; femoral vein; atrial septal defect; atrial septal defect occluder

DOI：

10.7507/1007-4848.201810016

Video：

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Objective To introduce the application of transcatheter closure of multi-fenestrated atrial septal defect (ASD) via femoral vein under ultrasound guidance with amplatzer cribriform occluder (ACO) and atrial septal defect occluder (ASDO), as well as to assess its feasibility, effectiveness and safety. Methods The clinical data of 48 patients with fenestrated ASD occluded via femoral vein under ultrasound guidance from December 2015 to May 2018 in our hospital were retrospectively analyzed, including 17 males and 31 females, aged 10 months to 51 years, an average of 11.50±13.86 years, and weighting 6-79 (27.00±20.14) kg. Among 48 patients with fenestrated ASD, 12 patients had double-foramen and 13 atrial septal aneurysm combined with defects and 23 multi-foramen. All patients underwent transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) to complete the closure of fenestrated ASD. Ultrasound, electrocardiogram and chest X-ray were reviewed the next day after surgery to evaluate the curative effect. Results Forty-eight patients with ASD were treated with 49 occluders, due to one patient with two occluders. There were 29 ASDO (8-26 mm) and 20 ACO (18-34 mm). During the operation, TTE/TEE examination showed that 48 patients were completely occluded, 13 patients showed fine bundle shunt in the unreleased push notification rod, and 9 patients had fine bundle shunt after the release of push notification rod. Fine bundle shunt was found in 8 patients 24 hours after operation, and microshunt was found in 3 patients 1 year after operation. All the patients were followed up. The occluder position was good. The right heart was reduced in different degrees, and the X-ray showed that the pulmonary blood was reduced in different degrees. No arrhythmia was found by electrocardiogram after operation. Conclusion It is a safe and effective method to use ACO and ASDO to occlude ASD through femoral approach under ultrasound guidance.

Citation： SUN Bao, CHENG Duan, LI Bo, HE Guibao, WANG Haifeng, Ahati, Elias, SHENG Xi, LI Jinpeng, Saddam Hussein, YU Guojun, ZHAN Shusheng, ZHANG Ling. Evaluation of the effectiveness of transcatheter closure of fenestrated atrial septal defect via femoral vein under ultrasound guidance. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(9): 889-894. doi: 10.7507/1007-4848.201810016 Copy

1.	逄坤靜, 趙星, 孟紅, 等. 經胸及經食管超聲引導經皮房間隔缺損封堵術. 中國循環雜志, 2014, 29(z1): 180.
2.	Pedra CA, Fontes-Pedra SR, Esteves CA, et al. Multiple atrial septal defects and patent ductus arteriosus: successful outcome using two Amplatzer septal occluders and Gianturco coils. Cathet Cardiovasc Diagn, 1998, 45(3): 257-259.
3.	米燕萍, 劉潔瓊. 食管超聲在經胸小切口直視房間隔缺損封堵術中的作用. 中國藥物與臨床, 2014, 14(2): 208-209.
4.	向仕釗, 朱燚, 楊明洋. 房間隔缺損患者右心血流動力學研究. 中華生物醫學工程雜志, 2018, 24(1): 52-55.
5.	Zanchetta M, Rigatelli G, Pedon L, et al. Catheter closure of perforated secundum atrial septal defect under intracardiac echocardiographic guidance using a single amplatzer device: feasibility of a new method. J Invasive Cardiol, 2005, 17(5): 262-265.
6.	Szkutnik M, Kusa J, Bialkowski J. The use of two Amplatzer "Cribriform" Septal Occluders to close multiple postinfarction ventricular septal defects. Tex Heart Inst J, 2008, 35(3): 362-364.
7.	逄坤靜, 王浩, 孟紅, 等. 經胸二維超聲心動圖引導兒童房間隔缺損經皮封堵治療術. 中華超聲影像學雜志, 2014, 23(7): 573-576.
8.	中國醫師協會心血管內科分會先心病工作委員會. 常見先天性心臟病介入治療中國專家共識一、房間隔缺損介入治療. 介入放射學雜志, 2011, 20(1): 3-9.
9.	Hijazi ZM, Bova S, Rhodes J. Simultaneous transcatheter closure of two secundum atrial septal defects using the Amplatzer septal occluder. J Interv Cardiol, 1998, 11(3): 181-184.
10.	Masseli J, Bertog S, Stanczak L, et al. Transcatheter closure of multiple interatrial communications. Catheter Cardiovasc Interv, 2013, 81(5): 825-836.
11.	Butera G, Romagnoli E, Saliba Z, et al. Percutaneous closure of multiple defects of the atrial septum: procedural results and long-term follow-up. Catheter Cardiovasc Interv, 2010, 76(1): 121-128.
12.	中國兒科雜志編輯委員會, 中華醫學雜志英文版編輯委員會. 先天性心臟病經導管介入治療指南. 中華兒科雜志, 2004, 42(3): 234-23914.
13.	徐中英, 徐立, 戴汝平, 等. 經導管植入Amplatzer封堵器治療多孔的房間隔缺損及其初步療效評價. 中國介入心臟病學雜志, 2001, 9(3): 125-127.
14.	Awad SM, Garay FF, Cao QL, et al. Multiple Amplatzer septal occluder devices for multiple atrial communications: immediate and long-term follow-up results. Catheter Cardiovasc Interv, 2007, 70(2): 265-273.
15.	宋治遠, 何國祥, 舒茂琴, 等. 經導管封堵成人多孔型房間隔缺損的體會. 中國循環雜志, 2005, 20(1): 25-27.
16.	Bramlet MT, Hoyer MH. Single pediatric center experience with multiple device implantation for complex secundum atrial septal defects. Catheter Cardiovasc Interv, 2008, 72(4): 531-537.
17.	Wang JK, Tsai SK, Wu MH, et al. Short- and intermediate-term results of transcatheter closure of atrial septal defect with the Amplatzer Septal Occluder. Am Heart J, 2004, 148(3): 511-517.
18.	Numan M, El Sisi A, Tofeig M, et al. Cribriform amplatzer device closure of fenestrated atrial septal defects: feasibility and technical aspects. Pediatr Cardiol, 2008, 29(3): 530-535.
19.	董建增, 湯日波, 馬長生, 等. 房間隔缺損經導管封堵術后房間隔穿刺一例. 中國介入心臟病學雜志, 2008, 16(3): 178.
20.	Majunke N, Bialkowski J, Wilson N, et al. Closure of atrial septal defect with the Amplatzer septal occluder in adults. Am J Cardiol, 2009, 103(4): 550-554.
21.	Visconti KJ, Bichell DP, Jonas RA, et al. Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation, 1999, 100(19 Suppl): I145-I150.

1. 逄坤靜, 趙星, 孟紅, 等. 經胸及經食管超聲引導經皮房間隔缺損封堵術. 中國循環雜志, 2014, 29(z1): 180.
2. Pedra CA, Fontes-Pedra SR, Esteves CA, et al. Multiple atrial septal defects and patent ductus arteriosus: successful outcome using two Amplatzer septal occluders and Gianturco coils. Cathet Cardiovasc Diagn, 1998, 45(3): 257-259.
3. 米燕萍, 劉潔瓊. 食管超聲在經胸小切口直視房間隔缺損封堵術中的作用. 中國藥物與臨床, 2014, 14(2): 208-209.
4. 向仕釗, 朱燚, 楊明洋. 房間隔缺損患者右心血流動力學研究. 中華生物醫學工程雜志, 2018, 24(1): 52-55.
5. Zanchetta M, Rigatelli G, Pedon L, et al. Catheter closure of perforated secundum atrial septal defect under intracardiac echocardiographic guidance using a single amplatzer device: feasibility of a new method. J Invasive Cardiol, 2005, 17(5): 262-265.
6. Szkutnik M, Kusa J, Bialkowski J. The use of two Amplatzer "Cribriform" Septal Occluders to close multiple postinfarction ventricular septal defects. Tex Heart Inst J, 2008, 35(3): 362-364.
7. 逄坤靜, 王浩, 孟紅, 等. 經胸二維超聲心動圖引導兒童房間隔缺損經皮封堵治療術. 中華超聲影像學雜志, 2014, 23(7): 573-576.
8. 中國醫師協會心血管內科分會先心病工作委員會. 常見先天性心臟病介入治療中國專家共識一、房間隔缺損介入治療. 介入放射學雜志, 2011, 20(1): 3-9.
9. Hijazi ZM, Bova S, Rhodes J. Simultaneous transcatheter closure of two secundum atrial septal defects using the Amplatzer septal occluder. J Interv Cardiol, 1998, 11(3): 181-184.
10. Masseli J, Bertog S, Stanczak L, et al. Transcatheter closure of multiple interatrial communications. Catheter Cardiovasc Interv, 2013, 81(5): 825-836.
11. Butera G, Romagnoli E, Saliba Z, et al. Percutaneous closure of multiple defects of the atrial septum: procedural results and long-term follow-up. Catheter Cardiovasc Interv, 2010, 76(1): 121-128.
12. 中國兒科雜志編輯委員會, 中華醫學雜志英文版編輯委員會. 先天性心臟病經導管介入治療指南. 中華兒科雜志, 2004, 42(3): 234-23914.
13. 徐中英, 徐立, 戴汝平, 等. 經導管植入Amplatzer封堵器治療多孔的房間隔缺損及其初步療效評價. 中國介入心臟病學雜志, 2001, 9(3): 125-127.
14. Awad SM, Garay FF, Cao QL, et al. Multiple Amplatzer septal occluder devices for multiple atrial communications: immediate and long-term follow-up results. Catheter Cardiovasc Interv, 2007, 70(2): 265-273.
15. 宋治遠, 何國祥, 舒茂琴, 等. 經導管封堵成人多孔型房間隔缺損的體會. 中國循環雜志, 2005, 20(1): 25-27.
16. Bramlet MT, Hoyer MH. Single pediatric center experience with multiple device implantation for complex secundum atrial septal defects. Catheter Cardiovasc Interv, 2008, 72(4): 531-537.
17. Wang JK, Tsai SK, Wu MH, et al. Short- and intermediate-term results of transcatheter closure of atrial septal defect with the Amplatzer Septal Occluder. Am Heart J, 2004, 148(3): 511-517.
18. Numan M, El Sisi A, Tofeig M, et al. Cribriform amplatzer device closure of fenestrated atrial septal defects: feasibility and technical aspects. Pediatr Cardiol, 2008, 29(3): 530-535.
19. 董建增, 湯日波, 馬長生, 等. 房間隔缺損經導管封堵術后房間隔穿刺一例. 中國介入心臟病學雜志, 2008, 16(3): 178.
20. Majunke N, Bialkowski J, Wilson N, et al. Closure of atrial septal defect with the Amplatzer septal occluder in adults. Am J Cardiol, 2009, 103(4): 550-554.
21. Visconti KJ, Bichell DP, Jonas RA, et al. Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation, 1999, 100(19 Suppl): I145-I150.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Evaluation of the effectiveness of transcatheter closure of fenestrated atrial septal defect via femoral vein under ultrasound guidance

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