Intracardiac Echocardiographic Guidance during Transcatheter Device Closure of Atrial Septal Defect and Patent Foramen Ovale

Michael G. Earing, Allison K. Cabalka, James B. Seward, Charles J Bruce, Guy S. Reeder, Donald J. Hagler

Research output: Contribution to journalArticle

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Abstract

Objectives: To describe our experience with intracardiac echocardiographic (ICE) guidance during transcatheter device closure of atrial septal defect (ASD) and patent foramen ovale (PFO) and to describe a detailed stepwise approach for performing ICE examinations. Patients and Methods: We reviewed the ICE results of all patients who underwent transcatheter device closure of ASD/PFO at the Mayo Clinic in Rochester, Minn, between October 2000 and November 2002 Conscious sedation was used, and all ICE studies were performed using a diagnostic ultrasound catheter. Results: Ninety-four patients (47 male; median age, 51 years [range, 17-81 years]) underwent ICE during transcatheter device closure of ASD/PFO. Total procedure time was 28 minutes (range, 27-320 minutes). ICE identified a previously unrecognized anatomical diagnosis in 32 of 94 patients. An additional ASD or PFO was found in 16 patients; a redundant atrial septum or an atrial septal aneurysm was found in 12 patients. There were few ICE complications (4%): 3 patients developed atrial fibrillation, and 1 developed supraventricular tachycardia; of these 4, 2 resolved spontaneously, and 2 required cardioversion with no recurrence. Conclusion: ICE provides anatomical detail of ASD/PFO and cardiac structures facilitating congenital cardiac interventional procedures. ICE eliminates major drawbacks related to the use of transesophageal echocardiographic guidance for transcatheter device closure of ASD/PFO, specifically problems related to airway management. Finally, ICE gives the interventional cardiologist the ability to control all aspects of imaging without relying on additional echocardiographic support. We believe that ICE should be considered the preferred imaging technique for guidance of transcatheter device closure of ASD/PFO in adults and larger pediatric patients.

Original languageEnglish (US)
Pages (from-to)24-34
Number of pages11
JournalMayo Clinic Proceedings
Volume79
Issue number1
StatePublished - 2004

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Patent Foramen Ovale
Atrial Heart Septal Defects
Equipment and Supplies
Atrial Septum
Conscious Sedation
Electric Countershock
Supraventricular Tachycardia
Airway Management
Atrial Fibrillation
Aneurysm
Ultrasonography
Catheters
Pediatrics
Recurrence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Intracardiac Echocardiographic Guidance during Transcatheter Device Closure of Atrial Septal Defect and Patent Foramen Ovale. / Earing, Michael G.; Cabalka, Allison K.; Seward, James B.; Bruce, Charles J; Reeder, Guy S.; Hagler, Donald J.

In: Mayo Clinic Proceedings, Vol. 79, No. 1, 2004, p. 24-34.

Research output: Contribution to journalArticle

Earing, Michael G. ; Cabalka, Allison K. ; Seward, James B. ; Bruce, Charles J ; Reeder, Guy S. ; Hagler, Donald J. / Intracardiac Echocardiographic Guidance during Transcatheter Device Closure of Atrial Septal Defect and Patent Foramen Ovale. In: Mayo Clinic Proceedings. 2004 ; Vol. 79, No. 1. pp. 24-34.
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