Clinical efficacy of trans-jugular transcatheter closure of atrial septal defect solely under echocardiography guidance in infants_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHI Hao , PAN Xiangbin , WANG Shouzheng ,  XIE Yongquan

Center of Structural Heart Disease, Fuwai Hospital, Chinese Academy of Medical Science, National Center for Cardiovascular Diseases, Beijing, 100037, P.R.China;

Corresponding?author：

XIE Yongquan, Email: 18610233818@163.com

Keywords：

Atrial septal defect; echocardiography; internal jugular vein; interventional treatment

DOI：

10.7507/1007-4848.202003143

Video：

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Objective To explore the key points, indications and safety of trans-jugular transcatheter closure of atrial septal defect (ASD) in infants.Methods The clinical data of 53 infants with ASD from January 2017 to May 2019 in our hospital were retrospectively reviewed. There were 20 males and 33 females with the age of 1.2 (0.5-2.9) years, and body weight of 9.0 (6.8-10.6) kg. The ASD diameter was 9.8 (8.0-14.0) mm. Thirty-one patients were treated under the guidance of transesophageal ultrasound (TEE), and the other 22 patients under the guidance of transthoracic echocardiography (TTE). We used the steerable curved sheath through the internal jugular vein under the guidance of echocardiography, and the average occluder size was 13.5±4.5 mm.Results All of the 53 patients were successfully occluded, and none of them changed to radiation-guided or transthoracic surgery. Postoperative hospital stay was 3.35±0.70 d. There was no complication such as peripheral vascular injury, occluder malposition or displacement, serious arrhythmia or pericardial effusion. The patients were followed up for 14.3±5.1 months without arrhythmia, residual shunt, occluder malposition or displacement or thrombus.Conclusion Echocardiography-guided trans-jugular closure of ASD for infants with low weight and large ASD shunt or patients with inferior vena cava abnormalities not suitable for femoral vein treatment, not only overcomes the radiation risk of radiation guidance, but also maintains the advantages of minimal invasiveness and safety, providing a new treatment option for such patients.

Citation： SHI Hao, PAN Xiangbin, WANG Shouzheng, XIE Yongquan. Clinical efficacy of trans-jugular transcatheter closure of atrial septal defect solely under echocardiography guidance in infants. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(6): 645-648. doi: 10.7507/1007-4848.202003143 Copy

1.	Moore J, Hegde S, El-Said H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv, 2013, 6(5): 433-442.
2.	Roguin A, Goldstein J, Bar O, et al. Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol, 2013, 111(9): 1368-1372.
3.	Bacher K, Bogaert E, Lapere R, et al. Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation, 2005, 111(1): 83-89.
4.	Cohen S, Liu A, Gurvitz M, et al. Exposure to low-dose ionizing radiation from cardiac procedures and malignancy risk in adults with congenital heart disease. Circulation, 2018, 137(13): 1334-1345.
5.	Baysson H, Réhel JL, Boudjemline Y, et al. Risk of cancer associated with cardiac catheterization procedures during childhood: a cohort study in France. BMC Public Health, 2013, 13: 266.
6.	Meinel FG, Nance JW Jr, Harris BS, et al. Radiation risks from cardiovascular imaging tests. Circulation, 2014, 130(5): 442-445.
7.	Andreassi MG, Ait-Ali L, Botto N, et al. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur Heart J, 2006, 27(22): 2703-2708.
8.	Modan B, Keinan L, Blumstein T, et al. Cancer following cardiac catheterization in childhood. Int J Epidemiol, 2000, 29(3): 424-428.
9.	Feltes TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation, 2011, 123(22): 2607-2652.
10.	Butera G, De Rosa G, Chessa M, et al. Transcatheter closure of atrial septal defect in young children: results and follow-up. J Am Coll Cardiol, 2003, 42(2): 241-245.
11.	Bartakian S, Fagan TE, Schaffer MS, et al. Device closure of secundum atrial septal defects in children. JACC Cardiovasc Interv, 2012, 5(11): 1178-1184.
12.	Petit CJ, Justino H, Pignatelli RH, et al. Percutaneous atrial septal defect closure in infants and toddlers: predictors of success. Pediatr Cardiol, 2013, 34(2): 220-225.
13.	Butera G, Lovin N, Basile DP. How to deal with atrial septal defect closure from right internal jugular vein: Role of venous-arterial circuit for sizing and over-the-wire device implantation. Catheter Cardiovasc Interv, 2017, 89(1): 120-123.
14.	宋書波, 范太兵, 等. 經頸內靜脈應用可調彎鞘輸送鞘封堵房間隔缺損. 中華實驗外科雜志, 2017, 34(7): 1250.
15.	楊超, 廖勝杰, 方劍, 等. 超聲引導下經右頸內靜脈可調彎鞘行房間隔缺損封堵術的臨床應用. 臨床心血管病雜志, 2016, 32(12): 1201-1203.
16.	張大偉, 潘湘斌, 李萍, 等. 單純超聲引導經頸靜脈封堵治療嬰幼兒房間隔缺損. 中華醫學雜志, 2019, 99(6): 458-461.
17.	潘湘斌, 歐陽文斌, 王首正, 等. 單純超聲引導下經頸靜脈室間隔缺損封堵術的探索研究. 中國循環雜志, 2015, 30(12): 1204-1207.

1. Moore J, Hegde S, El-Said H, et al. Transcatheter device closure of atrial septal defects: a safety review. JACC Cardiovasc Interv, 2013, 6(5): 433-442.
2. Roguin A, Goldstein J, Bar O, et al. Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol, 2013, 111(9): 1368-1372.
3. Bacher K, Bogaert E, Lapere R, et al. Patient-specific dose and radiation risk estimation in pediatric cardiac catheterization. Circulation, 2005, 111(1): 83-89.
4. Cohen S, Liu A, Gurvitz M, et al. Exposure to low-dose ionizing radiation from cardiac procedures and malignancy risk in adults with congenital heart disease. Circulation, 2018, 137(13): 1334-1345.
5. Baysson H, Réhel JL, Boudjemline Y, et al. Risk of cancer associated with cardiac catheterization procedures during childhood: a cohort study in France. BMC Public Health, 2013, 13: 266.
6. Meinel FG, Nance JW Jr, Harris BS, et al. Radiation risks from cardiovascular imaging tests. Circulation, 2014, 130(5): 442-445.
7. Andreassi MG, Ait-Ali L, Botto N, et al. Cardiac catheterization and long-term chromosomal damage in children with congenital heart disease. Eur Heart J, 2006, 27(22): 2703-2708.
8. Modan B, Keinan L, Blumstein T, et al. Cancer following cardiac catheterization in childhood. Int J Epidemiol, 2000, 29(3): 424-428.
9. Feltes TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation, 2011, 123(22): 2607-2652.
10. Butera G, De Rosa G, Chessa M, et al. Transcatheter closure of atrial septal defect in young children: results and follow-up. J Am Coll Cardiol, 2003, 42(2): 241-245.
11. Bartakian S, Fagan TE, Schaffer MS, et al. Device closure of secundum atrial septal defects in children. JACC Cardiovasc Interv, 2012, 5(11): 1178-1184.
12. Petit CJ, Justino H, Pignatelli RH, et al. Percutaneous atrial septal defect closure in infants and toddlers: predictors of success. Pediatr Cardiol, 2013, 34(2): 220-225.
13. Butera G, Lovin N, Basile DP. How to deal with atrial septal defect closure from right internal jugular vein: Role of venous-arterial circuit for sizing and over-the-wire device implantation. Catheter Cardiovasc Interv, 2017, 89(1): 120-123.
14. 宋書波, 范太兵, 等. 經頸內靜脈應用可調彎鞘輸送鞘封堵房間隔缺損. 中華實驗外科雜志, 2017, 34(7): 1250.
15. 楊超, 廖勝杰, 方劍, 等. 超聲引導下經右頸內靜脈可調彎鞘行房間隔缺損封堵術的臨床應用. 臨床心血管病雜志, 2016, 32(12): 1201-1203.
16. 張大偉, 潘湘斌, 李萍, 等. 單純超聲引導經頸靜脈封堵治療嬰幼兒房間隔缺損. 中華醫學雜志, 2019, 99(6): 458-461.
17. 潘湘斌, 歐陽文斌, 王首正, 等. 單純超聲引導下經頸靜脈室間隔缺損封堵術的探索研究. 中國循環雜志, 2015, 30(12): 1204-1207.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy of trans-jugular transcatheter closure of atrial septal defect solely under echocardiography guidance in infants

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