title: Transesophageal echocardiography and intracardiac echocardiography differently predict potential technical challenges or failures of interatrial shunts catheter-based closure.
abstract: We sought to prospectively assess the role of transesophageal (TEE) and intracardiac echocardiography (ICE) in detecting potential technical difficulties or failures in patients submitted to interatrial shunts percutaneous closure. We prospectively enrolled 46 consecutive patients (mean age 35+/-28, 8 years, 30 female) referred to our center for catheter-based closure of interatrial shunts. All patients were screened with TEE before the intervention. Patients who met the inclusion criteria underwent ICE study before the closure attempt (40 patients). TEE detected potential technical difficulties in 22.5% (9/40) patients, whereas ICE detected technical difficulties in 32.5% (13/40 patients). In patients with positive TEE/ICE the procedural success (92.4% versus 100% and, P = ns) and follow-up failure rate (7.7% versus 0%, P = ns) were similar to patients with negative TEE/ICE, whereas the fluoroscopy time (7 +/- 1.2 versus 5 +/- 0.7 minutes, P < 0.03), the procedural time (41 +/- 4.1 versus 30 +/- 8.2 minutes, P +/- 0.03), and technical difficulties rate (23.1% versus 0%, P = 0.013) were higher. Differences between ICE and TEE in the evaluation of rims, measurement of ASD or fossa ovalis, and detection of venous valve and embryonic septal membrane remnants impacted on technical challenges and on procedural and fluoroscopy times but did not influence the success rate and follow-up failure rate.
authors.affiliation: Rovigo General Hospital, Interventional Cardiology Unit, 18 Legnago, Verona, Italy. jackyheart@hotmail.com
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigatelli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rigateli
authors.forename: Paolo
authors.initials: P
authors.lastname: Cardaioli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Braggion
authors.forename: Silvio
authors.initials: S
authors.lastname: Aggio
authors.forename: Massimo
authors.initials: M
authors.lastname: Giordan
authors.forename: Beatrice
authors.initials: B
authors.lastname: Magro
authors.forename: Alberto
authors.initials: A
authors.lastname: Nascimben
authors.forename: Alberto
authors.initials: A
authors.lastname: Favaro
authors.forename: Loris
authors.initials: L
authors.lastname: Roncon
authors.forename: Loris
authors.initials: L
authors.lastname: Rincon
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome