Pediatric Cardiology, Department of Pediatrics, Children's Hospital, China Medical University, No. 2, Yude Road, North District, Taichung, Taiwan, ROC.
Cheng-Hsin General Hospital and National Taiwan University, No 45, Cheng Hsin St., Beitou, Taipei, Taiwan, ROC.
Cardiovasc Ultrasound. 2020 Jun 17;18(1):21. doi: 10.1186/s12947-020-00202-5.
Continuous real-time echocardiographic monitoring is essential for guidance during ASD closure. However, transthoracic echocardiography (TTE) can only be implemented intermittently during fluoroscopy. We evaluate a novel approach to provide real-time imaging during the entire procedure.
We developed a custom-made TTE monitoring apparatus using artificial hand (AH-TTE) that enables real-time TTE images during atrial septal defect (ASD) closure. Thirty-two patients underwent successful device implantation using AH-TTE monitoring without complications. The median duration for real-time AH-TTE monitoring was 22 min and the median fluoroscopy time was 7.2 min. One case of pericardial effusion and one of transient bradycardia event due to air embolism was detected. All patients had uneventful recoveries.
Our simple and novel monitoring technique with AH-TTE provides TEE-like monitoring and may be a new alternative method for ASD closure. It gives real-time stable TTE images and minimizes radiation exposure for the interventional team during fluoroscopy.
连续实时超声心动图监测对于 ASD 封堵术的指导至关重要。然而，经胸超声心动图（TTE）只能在透视期间间歇性实施。我们评估了一种提供整个手术过程中实时成像的新方法。
我们使用人工手（AH-TTE）开发了一种定制的 TTE 监测设备，可在房间隔缺损（ASD）封堵过程中提供实时 TTE 图像。32 名患者成功地使用 AH-TTE 监测进行了设备植入，没有并发症。实时 AH-TTE 监测的中位数持续时间为 22 分钟，透视时间的中位数为 7.2 分钟。发现 1 例心包积液和 1 例因空气栓塞引起的短暂心动过缓事件。所有患者均恢复顺利。
我们使用 AH-TTE 的简单而新颖的监测技术提供了类似于 TEE 的监测，可能是 ASD 封堵的一种新的替代方法。它提供了实时稳定的 TTE 图像，并在透视期间最大限度地减少了介入团队的辐射暴露。
