Ozturk Semi, Gurbuz Ahmed Seyfettin, Efe Suleyman Cagan, Yılmaz Mehmet Fatih, Kırma Cevat
Department of Cardiology, Haseki Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Yunus Emre State Hospital, Eskişehir, Turkey.
Korean Circ J. 2017 Sep;47(5):762-768. doi: 10.4070/kcj.2017.0073. Epub 2017 Sep 11.
Balloon sizing remains the main technique for determining occluder device size for atrial septal defects (ASDs). New evidence has proposed that accurate estimation of device size could be possible without using the balloon technique. Operators have predicted the amount of possible enlargement depending on their experiences. Thus, selection criteria have mostly relied on personal observations and experiences. The objective of this study was to determine the relationship between age, sex, defect size, and deployed device size based on the balloon technique.
Sixty-six patients who underwent percutaneous ASD closure with a Cardi-O-Fix occluder between 2011 and 2012 were retrospectively evaluated. Patients whose maximum defect size and device size were available were included. Enlargement amount (EA) (device size-defect size) and enlargement ratio (ER) (EA/defect size) were calculated. The relationship between these 2 calculations and age, sex, and defect size were analyzed.
EA and ER were 5.2±3.6 mm (min: 0, max: 15, median: 5) and 39.3%±31.5% (min: 0, max: 125, median: 32), respectively. EA and ER did not differ between genders (p=0.800; p=0.430). EA and ER were not correlated with maximum defect size (p=0.310; p=0.050). EA and ER showed no correlation with age (p=0.970; p=0.640). However when patients were dichomotized based on age 40, ER was significantly lower in older group (p=0.030). Unexpectedly, no difference was observed between the 2 groups in terms of EA (p=0.110). Size of deployed device had a strong correlation with defect size measured with two-dimensional (2D) transesophageal echocardiography (TEE; device size=1.1177×TEE defect size+3.5297; R=0.84; p<0.010).
EA and ER did not show a significant correlation with sex and defect size in our study. Patients older than 40 had a significantly lower ER compared to younger patients. Device size was strongly correlated with defect size measured with TEE.
球囊扩张法仍是确定房间隔缺损（ASD）封堵器尺寸的主要技术。新证据表明，不使用球囊技术也有可能准确估计封堵器尺寸。操作人员根据自身经验预测可能的扩张量。因此，选择标准大多依赖个人观察和经验。本研究的目的是基于球囊技术确定年龄、性别、缺损大小与植入封堵器尺寸之间的关系。
回顾性评估了2011年至2012年间66例行Cardi - O - Fix封堵器经皮ASD封堵术的患者。纳入最大缺损尺寸和封堵器尺寸数据完整的患者。计算扩张量（EA）（封堵器尺寸 - 缺损尺寸）和扩张率（ER）（EA/缺损尺寸）。分析这两种计算结果与年龄、性别和缺损大小之间的关系。
EA和ER分别为5.2±3.6mm（最小值：0，最大值：15，中位数：5）和39.3%±31.5%（最小值：0，最大值：125，中位数：32）。EA和ER在性别间无差异（p = 0.800；p = 0.430）。EA和ER与最大缺损尺寸无相关性（p = 0.310；p = 0.050）。EA和ER与年龄无相关性（p = 0.970；p = 0.640）。然而，当根据年龄40岁对患者进行二分法分组时，老年组的ER显著较低（p = 0.030）。出乎意料的是，两组间EA无差异（p = 0.110）。植入封堵器的尺寸与经食管二维超声心动图（TEE）测量的缺损尺寸高度相关（封堵器尺寸 = 1.1177×TEE缺损尺寸 + 3.5297；R = 0.84；p < 0.010）。
在我们的研究中，EA和ER与性别及缺损大小无显著相关性。40岁以上患者的ER显著低于年轻患者。封堵器尺寸与TEE测量的缺损尺寸高度相关。
