A comparison between size of the occluder device and two-dimensional transoesophageal echocardiographic sizing of the ostium secundum atrial septal defect.
OBJECTIVE
Transcatheter closure of a secundum atrial septal defect (ASD II) has become an effective alternative for surgical treatment. In this study we evaluated the correlation between the two-dimensional transoesophageal echocardiographic (2D TEE) sizing of ASDs and the actual diameter of occluders in patients undergoing device closure.


METHODS
The records of 54 patients who underwent transcatheter ASD closure were reviewed. ASD characteristics and maximum defect diameter were evaluated using preprocedure 2D TEE images. Appropriate device size was determined by the balloon sizing method, which measures the balloon occlusive diameter (BOD) via TEE and fluoroscopy. ASD closure was performed under continuous TEE monitoring using the Amplatzer occluder in all patients.


RESULTS
The mean of the TEE-derived maximum defect diameter was significantly lower than the mean of the BOD (17.8 ± 4.5 vs 22.1 ± 5.1 mm; p < 0.001) and the mean size of the implanted occluder device (17.8 ± 4.5 vs 23.3 ± 5.1 mm; p < 0.001). However, a good correlation was found between the TEE-derived defect size and the BOD (BOD = 0.898 × TEE defect size + 6.212, R = 0.824; p < 0.001) and between the TEE measurement and the final size of the implanted Amplatzer (device size = 0.928 × TEE defect size + 6.853, R = 0.822; p < 0.001).


CONCLUSIONS
2D TEE may provide a good equation to predict the BOD or the size of the occluder device; however, further studies are needed to investigate whether it is feasible to perform transcatheter ASD occlusion without balloon sizing.
Interventional Cardiology Department, Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.
Alimohammad
A
Hajizeinali
Hakimeh
H
Sadeghian
Mehrnaz
M
Rezvanfard
Mohammad
M
Alidoosti
Arezoo
A
Zoroufian
Marat A
MA
Volman
D000293:Adolescent; D000328:Adult; D000368:Aged; D021721:Balloon Occlusion; D002648:Child; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D005260:Female; D005471:Fluoroscopy; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000601:surgery*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019919:Prosthesis Implantation; D055989:Septal Occluder Device / Q000706:statistics & numerical data*; D055815:Young Adult