Sizing of Atrial Septal Defects by Intracardiac Echocardiography for Device Closures

Chien, Jen-Chung; Hwang, Betau; Fu, Yun-Ching; Lee, Pi-Chang; Hsieh, Kai-Sheng; Jan, Sheng-Ling

doi:10.1016/S1726-4901(08)70090-X

« Previous Next »Journal of the Chinese Medical Association
Volume 71, Issue 8 , Pages 399-405, August 2008

Sizing of Atrial Septal Defects by Intracardiac Echocardiography for Device Closures

Jen-Chung Chien
- Department of Pediatrics, Lo-Tung Pohai Hospital, Ilan, Taiwan, R.O.C.
- Department of Pediatrics, Taipei Veterans General Hospital, Taiwan, R.O.C.
Betau Hwang
- Department of Pediatrics, Taipei Veterans General Hospital, Taiwan, R.O.C.
- Department of Pediatrics, Zhongxiao Branch, Taipei City Hospital, Taiwan, R.O.C.
- Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
- Correspondence to: Dr Betau Hwang, Department of Pediatrics, Zhongxiao Branch, Taipei City Hospital, 87, Tongde Road, Nangang District, Taipei 115, Taiwan, R.O.C.
Yun-Ching Fu
- Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
Pi-Chang Lee
- Department of Pediatrics, Taipei Veterans General Hospital, Taiwan, R.O.C.
- Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
Kai-Sheng Hsieh
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
Sheng-Ling Jan
- Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.

Received 29 February 2008; accepted 18 June 2008.

Background

Transcatheter closure of a secundum atrial septal defect (ASD) has become an effective method for surgical treatment. In this study, we evaluated the feasibility and accuracy of intracardiac echocardiography (ICE) for sizing ASDs compared with conventional methods.

Methods

Between January 2004 and December 2006, 270 patients underwent transcatheter closure of secundum ASD by using septal occluders. For 142 patients, the procedure was guided by transesophageal echocardiography (TEE), and for 128 patients by ICE. We compared the maximal diameters of the ASDs obtained during angiocardiography, transthoracic echocardiography (TTE), ICE, and TEE with balloon-stretched sizes ascertained by using a sizing plate.

Results

ASD diameters measured with the sizing plate were significantly correlated with those measured with ICE (r = 0.963), TEE (r = 0.912), angiography (r = 0.88), and TTE (r = 0.85). The predicted stretched diameter of the ASDs, i.e. (nonstretched diameter measured with ICE ×1.07) +3.23 mm, agreed well with that measured by using a sizing plate (Ri = 0.974).