Appropriate device selection for transcatheter atrial septal defect closure using three-dimensional transesophageal echocardiography

Hiroki Kitakata, Yuji Itabashi, Hideaki Kanazawa, Kotaro Miura, Mai Kimura, Keitaro Shinada, Marjolein C. de Jongh, Jin Endo, Hikaru Tsuruta, Mitsushige Murata, Akio Kawamura, Mitsuru Murata, Keiichi Fukuda

研究成果: Article査読

2 被引用数 (Scopus)


Detail morphological evaluation for ASD is essential to achieve successful transcatheter closure. Three-dimensional transesophageal echocardiography (3D-TEE) is emerging, but few studies have comprehensively verified the usefulness of 3D-TEE. We divided 329 patients who underwent transcatheter ASD closure at our university hospital into 157 in the Conventional group evaluated with 2-dimensional transesophageal echocardiography and balloon sizing (BS), and 172 in the 3D-TEE group evaluated with 3D-TEE additionally. We assessed usefulness of 3D-TEE and consider appropriate device selection procedure. Overall, the percentage with re-sizing of device tended to be lower in the 3D-TEE group than in the Conventional group (10.1% vs 6.0%, p = 0.187). Among preprocedural modalities, the device size was mainly decided based on the BS diameter. A logistic regression analysis demonstrated that large atrial septum aneurysms (ASA) were associated with a ≥ 2 mm discrepancy of the BS diameter from the preprocedural 3D-TEE diameter (p < 0.05). Compared to the Amplatzer Septal Occluder, the differences in device size and the preprocedural ASD measurement were greater when using the Occlutech Figulla Flex II Occluder (FFII). Particularly, among the patients implanted with FFIIs, the discrepancies of the device size from the 3D-TEE measurement were greater in patients with large ASA than those with small ASA. Preprocedural 3D-TEE is useful to select the appropriate device size. Particularly, it is necessary to select a much larger device than that derived from the preprocedural 3D-TEE measurement when using FFII in patients with a septal aneurysm.

ジャーナルInternational Journal of Cardiovascular Imaging
出版ステータスPublished - 2021 4月

ASJC Scopus subject areas

  • 放射線学、核医学およびイメージング
  • 循環器および心血管医学


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