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.	逄坤静, 赵星, 孟红, 等. 经胸及经食管超声引导经皮房间隔缺损封堵术. 中国循环杂志, 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, 刘洁琼. 食管超声在经胸小切口直视房间隔缺损封堵术中的作用. 中国药物与临床, 2014, 14(2): 208-209.
4.	向仕钊, 朱燚, 杨明洋. 房间隔缺损患者右心血流动力学研究. 中华生物医学工程杂志, 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.	逄坤静, 王浩, 孟红, 等. 经胸二维超声心动图引导儿童房间隔缺损经皮封堵治疗术. 中华超声影像学杂志, 2014, 23(7): 573-576.
8.	中国医师协会心血管内科分会先心病工作委员会. 常见先天性心脏病介入治疗中国专家共识一、房间隔缺损介入治疗. 介入放射学杂志, 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.	中国儿科杂志编辑委员会, 中华医学杂志英文版编辑委员会. 先天性心脏病经导管介入治疗指南. 中华儿科杂志, 2004, 42(3): 234-23914.
13.	徐中英, 徐立, 戴汝平, 等. 经导管植入Amplatzer封堵器治疗多孔的房间隔缺损及其初步疗效评价. 中国介入心脏病学杂志, 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.	宋治远, 何国祥, 舒茂琴, 等. 经导管封堵成人多孔型房间隔缺损的体会. 中国循环杂志, 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, 汤日波, 马长生, 等. 房间隔缺损经导管封堵术后房间隔穿刺一例. 中国介入心脏病学杂志, 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. 逄坤静, 赵星, 孟红, 等. 经胸及经食管超声引导经皮房间隔缺损封堵术. 中国循环杂志, 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, 刘洁琼. 食管超声在经胸小切口直视房间隔缺损封堵术中的作用. 中国药物与临床, 2014, 14(2): 208-209.
4. 向仕钊, 朱燚, 杨明洋. 房间隔缺损患者右心血流动力学研究. 中华生物医学工程杂志, 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. 逄坤静, 王浩, 孟红, 等. 经胸二维超声心动图引导儿童房间隔缺损经皮封堵治疗术. 中华超声影像学杂志, 2014, 23(7): 573-576.
8. 中国医师协会心血管内科分会先心病工作委员会. 常见先天性心脏病介入治疗中国专家共识一、房间隔缺损介入治疗. 介入放射学杂志, 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. 中国儿科杂志编辑委员会, 中华医学杂志英文版编辑委员会. 先天性心脏病经导管介入治疗指南. 中华儿科杂志, 2004, 42(3): 234-23914.
13. 徐中英, 徐立, 戴汝平, 等. 经导管植入Amplatzer封堵器治疗多孔的房间隔缺损及其初步疗效评价. 中国介入心脏病学杂志, 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. 宋治远, 何国祥, 舒茂琴, 等. 经导管封堵成人多孔型房间隔缺损的体会. 中国循环杂志, 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, 汤日波, 马长生, 等. 房间隔缺损经导管封堵术后房间隔穿刺一例. 中国介入心脏病学杂志, 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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