Siagian Sisca Natalia, Prakoso Radityo, Putra Bayushi Eka, Kurniawati Yovi, Lelya Olfi, Sembiring Aditya Agita, Atmosudigdo Indriwanto Sakidjan, Roebiono Poppy Surwianti, Rahajoe Anna Ulfah, Harimurti Ganesja Moelia, Mendel Brian, Christianto Christianto, Setiawan Moira, Lilyasari Oktavia
Division of Pediatric Cardiology and Congenital Heart Disease, Department of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Front Cardiovasc Med. 2022 May 23;9:885140. doi: 10.3389/fcvm.2022.885140. eCollection 2022.
Since the first successful percutaneous closure under transesophageal echocardiographic (TEE) guidance, many centers explored transcatheter procedures without fluoroscopy. This single-center study is aimed to show the feasibility and safety of percutaneous patent ductus arteriosus (PDA) closure under echocardiography-only guidance during our 1-year experience.
Patients with PDA were recruited for percutaneous PDA closure guided by either fluoroscopy or echocardiography-only in National Cardiovascular Center Harapan Kita (ClinicalTrials.gov Identifier: NCT05321849, clinicaltrials.gov/ct2/show/NCT05321849). Patients were evaluated clinically and radiologically using transthoracic echocardiography (TTE) at 6, 24, and 48 h after the procedure. The primary endpoint was the procedural success. Secondary endpoints were the procedural time and the rate of adverse events.
A total of 60 patients underwent transcatheter PDA closure, 30 patients with fluoroscopy and 30 patients with echocardiography guidance. All patients had successful PDA closure. There were only residual shunts, which were disappeared after follow-up in both groups, but one patient with a fluoroscopy-guided procedure had moderate tricuspid regurgitation with suspected thrombus in the tricuspid valve. The procedural time was not significantly different between the fluoroscopy and echocardiography groups.
自从在经食管超声心动图(TEE)引导下首次成功进行经皮封堵术以来,许多中心都在探索无荧光透视的经导管手术。这项单中心研究旨在展示在我们为期1年的经验中,仅在超声心动图引导下经皮动脉导管未闭(PDA)封堵术的可行性和安全性。
在国家心血管中心哈帕恩·基塔,招募患有PDA的患者进行经皮PDA封堵术,可采用荧光透视引导或仅超声心动图引导(ClinicalTrials.gov标识符:NCT05321849,clinicaltrials.gov/ct2/show/NCT05321849)。术后6小时、24小时和48小时,使用经胸超声心动图(TTE)对患者进行临床和影像学评估。主要终点是手术成功。次要终点是手术时间和不良事件发生率。
共有60例患者接受了经导管PDA封堵术,30例采用荧光透视引导,30例采用超声心动图引导。所有患者的PDA封堵均成功。两组均仅有残余分流,随访后均消失,但1例接受荧光透视引导手术的患者出现中度三尖瓣反流,三尖瓣疑似有血栓形成。荧光透视组和超声心动图组的手术时间无显著差异。