Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Jun;30(3):234-241.
doi: 10.1111/joic.12382. Epub 2017 Apr 25.

Intracardiac versus transesophageal echocardiography to guide transcatheter closure of interatrial communications: Nationwide trend and comparative analysis

Fahad Alqahtani  1 , Ashwin Bhirud  1 , Sami Aljohani  1 , James Mills  1 , Akram Kawsara  1 , Ashok Runkana  1 , Mohamad Alkhouli  1
Affiliations
Comparative Study

Intracardiac versus transesophageal echocardiography to guide transcatheter closure of interatrial communications: Nationwide trend and comparative analysis

Fahad Alqahtani et al. J Interv Cardiol. 2017 Jun.

Abstract

Objectives: This study aimed to assess current temporal trends in utilization of ICE versus TEE guided closure of interatrial communications, and to compare periprocedural complications and resource utilization between the two imaging modalities.

Background: While transesophageal echocardiography (TEE) has historically been used to guide percutaneous structural heart interventions, intracardiac echocardiography (ICE) is being increasingly utilized to guide many of these procedures such as closure of interatrial communications.

Methods: Using the Nationwide Inpatient Sample, all patients aged >18 years, who underwent ASD or PFO closure with either ICE or TEE guidance between 2003 and 2014 were included. Comparative analysis of outcomes and resource utilization was performed using a propensity score-matching model.

Results: ICE guidance for interatrial communication closure increased from 9.7% in 2003 to 50.6% in 2014. In the matched model, the primary endpoint of major adverse cardiovascular events occurred less frequently in the ICE group versus the TEE group (11.1% vs 14.3%, respectively, P = 0.008), mainly driven by less vascular complications in the ICE group (0.5% vs 1.3%, P = 0.045). Length of stay was shorter in the ICE group (3 ± 4 vs 4 ± 4 days, P < 0.0001). Cost was similar in the two groups 18 454 ± 17 035$ in the TEE group vs 18 278 ± 15 780$ in the ICE group (P = 0.75).

Conclusions: Intracardiac echocardiogram utilization to guide closure of interatrial communications has plateaued after a rapid rise throughout the 2000s. When utilized to guide interatrial communication closure procedure, ICE is as safe as TEE and does not increase cost or prolonged hospitalizations.

Keywords: atrial sep-tal defect; intracardiac echocardiography; patent foramen ovale; transcatheter closure; transesophageal echocardiography.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Flow diagram of patients’ selection from National Inpatient Sample (NIS) database
FIGURE 2
FIGURE 2
Temporal trends of intracardiac versus transesophageal echocardiography to guide transcatheter closure of ASD/PFO in the United States between 2003 and 2014. TEE, Transesophageal echocardiography; ICE, Intracardiac echocardiography
FIGURE 3
FIGURE 3
All adverse event of intracardiac versus transesophageal echocardiography to guide transcatheter closure of ASD/PFO in a propensity-matched cohort. TEE, Transesophageal echocardiography; ICE, Intracardiac echocardiography
FIGURE 4
FIGURE 4
In-hospital complications following intracardiac versus transesophageal echocardiography to guide transcatheter closure of ASD/PFO in a propensity-matched cohort
See this image and copyright information in PMC

References

    1. Bridges ND, Hellenbrand W, Latson L, et al. Transcatheter closure of patent foramen ovale after presumed paradoxical embolism. Circulation. 1992;86:1902–1908. - PubMed
    1. Valdes-Cruz LM, Sideris E, Sahn DJ, et al. Transvascular intracardiac applications of a miniaturized phased-array ultrasonic endoscope. Initial experience with intracardiac imaging in piglets. Circulation. 1991;83:1023–1027. - PubMed
    1. Seward JB, Packer DL, Chan RC, et al. Ultrasound cardioscopy: embarking on a new journey. Mayo Clin Proc. 1996;71:629–635. - PubMed
    1. Opotowsky AR, Landzberg MJ, Kimmel SE, et al. Percutaneous closure of patent foramen ovale and atrial septal defect in adults: the impact of clinical variables and hospital procedure volume on in-hospital adverse events. Am Heart J. 2009;157:867–874. - PubMed
    1. Singh V, Badheka AO, Patel NJ, et al. Influence of hospital volume on outcomes of percutaneous atrial septal defect and patent foramen ovale closure: a 10-years US perspective. Catheter Cardiovasc Interv. 2015;85:1073–1081. - PubMed

Publication types

MeSH terms