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
. 2020 Sep 7:2020:1462140.
doi: 10.1155/2020/1462140. eCollection 2020.

Microtransesophageal Echocardiographic Guidance during Percutaneous Interatrial Septal Closure without General Anaesthesia

Roel J R Snijder  1 , Laura E Renes  2 , Martin J Swaans  1 , Maarten Jan Suttorp  1 , Jurrien M Ten Berg  1 , Martijn C Post  1
Affiliations

Microtransesophageal Echocardiographic Guidance during Percutaneous Interatrial Septal Closure without General Anaesthesia

Roel J R Snijder et al. J Interv Cardiol. .

Abstract

Objective: To study the safety and efficacy of microtransesophageal echocardiography (micro-TEE) and TEE during percutaneous atrial septal defect (ASD) and patent foramen ovale (PFO) closure.

Background: TEE has proven to be safe during ASD and PFO closure under general anaesthesia. Micro-TEE makes it possible to perform these procedures under local anaesthesia. We are the first to describe the safety and efficacy of micro-TEE for percutaneous closure.

Methods: All consecutive patients who underwent ASD and PFO closure between 2013 and 2018 were included. The periprocedural complications were registered. Residual shunts were diagnosed using transthoracic contrast echocardiography (TTCE). All data were compared between the use of TEE or micro-TEE within the ASD and PFO groups separately.

Results: In total, 82 patients underwent ASD closure, 46 patients (49.1 ± 15.0 years) with TEE and 36 patients (47.8 ± 12.1 years) using micro-TEE guidance. Median device diameter was, respectively, 26 mm (range 10-40 mm) and 27 mm (range 10-35 mm). PFO closure was performed in 120 patients, 55 patients (48.6 ± 9.2 years, median device diameter 25 mm, range 23-35 mm) with TEE and 65 patients (mean age 51.0 ± 11.8 years, median device diameter 27 mm, range 23-35 mm) using micro-TEE. There were no major periprocedural complications, especially no device embolizations within all groups. Six months after closure, there was no significant difference in left-to-right shunt after ASD closure and no significant difference in right-to-left shunt after PFO closure using TEE or micro-TEE.

Conclusion: Micro-TEE guidance without general anaesthesia during percutaneous ASD and PFO closure is as safe as TEE, without a significant difference in the residual shunt rate after closure.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
The Occlutech ASD device (white arrow) using the transesophageal echocardiography (TEE) probe (a) and fluoroscopy (b). The black arrow indicates the TEE probe during fluoroscopy.
Figure 2
Figure 2
The Occlutech ASD device (white arrow) using the microtransesophageal echocardiography (micro-TEE) probe (a) and fluoroscopy (b). The black arrow indicates the micro-TEE probe during fluoroscopy.
See this image and copyright information in PMC

References

    1. Alqahtani F., Bhirud A., Aljohani S., et al. Intracardiac versus transesophageal echocardiography to guide transcatheter closure of interatrial communications: nationwide trend and comparative analysis. Journal of Interventional Cardiology. 2017;30(3):234–241. doi: 10.1111/joic.12382. - DOI - PMC - PubMed
    1. Xu W., Li J., Ye J., Yu J., Yu J. G., Zhang Z. Transesophageal echocardiography and fluoroscopy for percutaneous closure of atrial septal defects: a comparative study. Medicine (Baltimore) 2018;97(43) doi: 10.1097/md.0000000000012891.e12891 - DOI - PMC - PubMed
    1. Scacciatella P., Meynet I., Giorgi M., et al. Angiography vs. transesophageal echocardiography-guided patent foramen ovale closure: a propensity score matched analysis of a two-center registry. Echocardiography. 2018;35(6):834–840. doi: 10.1111/echo.13842. - DOI - PubMed
    1. Wunderlich N. C., Beigel R., Swaans M. J., Ho S. Y., Siegel R. J. Percutaneous interventions for left atrial appendage exclusion. JACC: Cardiovascular Imaging. 2015;8(4):472–488. doi: 10.1016/j.jcmg.2015.02.002. - DOI - PubMed
    1. Ho H. F., Chelliah A., Sable C. A. Evaluation of a second-generation microtransesophageal echocardiography transducer and software. World Journal for Pediatric and Congenital Heart Surgery. 2014;5(4):565–570. doi: 10.1177/2150135114542167. - DOI - PubMed

LinkOut - more resources