title: Preprocedural Transthoracic Echocardiography Can Predict Amplatzer Septal Occluder Device Size for Transcatheter Atrial Septal Defect Closure.
abstract: OBJECTIVE
  To evaluate whether preprocedural transthoracic echocardiography (TTE) can be used to predict Amplatzer septal occluder (ASO) size for device closure of atrial septal defect (ASD).
  
  
  METHODS
  Retrospective review of patients who underwent ASD device closure at our institution between August 2006 and August 2013 was performed. Patients with complex congenital heart disease, devices other than the ASO, multiple devices, or inadequate TTE images were excluded. Those who had transesophageal echocardiography (TEE)-guided device placement were evaluated. A blinded observer reviewed their preprocedural TTE images and applied a scaled formula to predict device size.
  
  
  RESULTS
  A total of 186 patients underwent ASO placement during the study period, 87 had TEE guidance, of which 45 met inclusion criteria. The mean predicted device size by the scaled formula was 18.0 ± 5.11 mm, compared to the mean implanted device size of 18.8 ± 5.22 mm. The mean absolute difference between each predicted and final deployed device size was 1.44 mm with 95% CI [1.08, 1.81]. The Pearson correlation showed that the predicted device size had a positive correlation coefficient of 0.94.
  
  
  CONCLUSIONS
  Preprocedural TTE assessment of ASD size using a scaling formula in patients with adequate TTE windows can accurately predict ASO device size and aid in device selection.
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: Serena P
authors.initials: SP
authors.lastname: Sah
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Bartakian
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: Howaida
authors.initials: H
authors.lastname: El-Said
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: Delaram P
authors.initials: DP
authors.lastname: Molkara
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Printz
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of California - San Diego, School of Medicine, Rady Children's Hospital, San Diego, Calif, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008954:Models, Biological; D015588:Observer Variation; D018579:Patient Selection; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055989:Septal Occluder Device
keywords: Amplatzer Septal Occluder; Atrial Septal Defect; Defect Sizing; Device Closure; Echocardiography