title: Transesophageal echocardiography guided patent ductus arteriosus occlusion with a duct occluder.
abstract: BACKGROUND
  Angiography and fluoroscopy are the standard methods to guide transcatheter occlusion of patent ductus arteriosus (PDA). The use of iodinated contrast agents and radiation exposure pose risks of animals and staff.
  
  
  OBJECTIVE
  To assess feasibility of transesophageal echocardiography (TEE) for device size selection and procedure monitoring for PDA occlusion with a duct occluder (DO) without the use of angiography.
  
  
  METHODS
  Eighty client-owned dogs with left-to-right PDA.
  
  
  METHODS
  Prospective study. Dogs with left-to-right PDA undergoing transcatheter occlusion were included. Procedures were performed without angiography and device size selection was based on TEE measurements. Procedures were monitored with simultaneous TEE and fluoroscopy and both methods were compared. Visualization of the ductus and dimensions obtained by TEE and transthoracic echocardiography (TTE) were compared.
  
  
  RESULTS
  Complete PDA occlusion was achieved in 79/80 cases. TEE was consistently superior to TTE for PDA visualization and the latter showed higher values for ductal dimensions when compared to the former. TEE provided adequate procedure monitoring in 73 cases (91%). Fluoroscopy exposure time (2.77 ± 1.2 minutes (mean, SD)) was lower than previously reported for the same procedure.
  
  
  CONCLUSIONS
  TEE is a useful and efficient tool for device size selection and can be used for procedure monitoring in most cases. Fluoroscopy exposure time can be reduced and the use of contrast agents can be avoided. However, fluoroscopy is required in a minority of cases when TEE monitoring is not feasible or incomplete and should be available for this procedure.
authors.affiliation: Department of Cardiology, Clinica Veterinaria Gran Sasso, Milan, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Silva
authors.forename: O
authors.initials: O
authors.lastname: Domenech
authors.forename: A
authors.initials: A
authors.lastname: Mavropoulou
authors.forename: P
authors.initials: P
authors.lastname: Oliveira
authors.forename: C
authors.initials: C
authors.lastname: Locatelli
authors.forename: C
authors.initials: C
authors.lastname: Bussadori
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D004283:Dog Diseases / Q000000981:diagnostic imaging*; D004285:Dogs; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000662:veterinary*; D004452:Echocardiography / Q000662:veterinary; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D005260:Female; D008297:Male; D011446:Prospective Studies
keywords: Canine; Congenital heart disease; Fluoroscopy; Interventional