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.	宋书波, 范太兵, 等. 经颈内静脉应用可调弯鞘输送鞘封堵房间隔缺损. 中华实验外科杂志, 2017, 34(7): 1250.
15.	杨超, 廖胜杰, 方剑, 等. 超声引导下经右颈内静脉可调弯鞘行房间隔缺损封堵术的临床应用. 临床心血管病杂志, 2016, 32(12): 1201-1203.
16.	张大伟, 潘湘斌, 李萍, 等. 单纯超声引导经颈静脉封堵治疗婴幼儿房间隔缺损. 中华医学杂志, 2019, 99(6): 458-461.
17.	潘湘斌, 欧阳文斌, 王首正, 等. 单纯超声引导下经颈静脉室间隔缺损封堵术的探索研究. 中国循环杂志, 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. 宋书波, 范太兵, 等. 经颈内静脉应用可调弯鞘输送鞘封堵房间隔缺损. 中华实验外科杂志, 2017, 34(7): 1250.
15. 杨超, 廖胜杰, 方剑, 等. 超声引导下经右颈内静脉可调弯鞘行房间隔缺损封堵术的临床应用. 临床心血管病杂志, 2016, 32(12): 1201-1203.
16. 张大伟, 潘湘斌, 李萍, 等. 单纯超声引导经颈静脉封堵治疗婴幼儿房间隔缺损. 中华医学杂志, 2019, 99(6): 458-461.
17. 潘湘斌, 欧阳文斌, 王首正, 等. 单纯超声引导下经颈静脉室间隔缺损封堵术的探索研究. 中国循环杂志, 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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