Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases and Hospital, Sher-e- Bangla Nagar, Dhaka 1207, Bangladesh.
Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Ther Adv Cardiovasc Dis. 2023 Jan-Dec;17:17539447231193290. doi: 10.1177/17539447231193290.
Secundum atrial septal defect (ASD) is treated following trans-catheter closure in alternative to surgical treatment. Per-intervention selection of device size with balloon occlusive diameter (BOD) often cause tearing or enlarging, causing arrhythmias and hypotension. We assessed the suitability of percutaneous device closure for ASD using 3-dimensional transthoracic echocardiography (3DTTE).
This study was conducted to investigate if 3DTTE could be an alternative of balloon sizing for selection of device size in atrial septal defect device closure.
It was a cross-sectional comparative study.
This study was conducted at the department of Pediatric Cardiology, Bangabandhu Sheikh Mujib Medical University for a period of 2 years. Thirty-three purposively selected secundum ASD patients suitable for device closure were included in the study. Ethical permission was taken from the Institutional Review Board and written consent was taken from each patient's guardian. In this study, 3DTTE derived ASD diameter and BOD were compared with that of deployed device size using correlation analysis.
Out of 33 patients, 63.6% were female and 36.4% were males had a mean age of 18.07 ± 14.58 years (range 2-55 years). Mean diameter of ASD measured by 2-dimensional (2D) and 3-dimensional (3D) echocardiography were 17.09 ± 6.08 mm and 21.30 ± 6.56 mm, respectively, yielding a significant difference ( < 0.001). 3D echocardiography derived ASDs diameter were highly correlated with device size than BOD and 2D echocardiography derived diameter (2D echocardiography: = 0.796, = <0.001, 3D echocardiography: = 0.960, = <0.001, BOD: = 0.840, = <0.001).
3DTTE can accurately measure ASD diameter and can be used as an alternate, effective, and safe method to select device size.
继发孔房间隔缺损（ASD）通常采用经导管封堵术替代外科手术治疗。介入治疗时，常根据球囊阻塞直径（BOD）选择封堵器的大小，但这可能会导致撕裂或扩大，引起心律失常和低血压。我们使用三维经胸超声心动图（3DTTE）评估 ASD 的经皮封堵器的适用性。
本研究旨在探讨 3DTTE 是否可替代球囊测量来选择房间隔缺损封堵器的大小。
这是一项横断面对比研究。
本研究在孟加拉国谢赫·穆吉布·医学大学儿科心脏病科进行，为期 2 年。共纳入 33 例适合使用封堵器治疗的继发孔 ASD 患者。本研究获得机构审查委员会的伦理许可，并获得每位患者监护人的书面同意。在本研究中，采用相关性分析比较 3DTTE 得出的 ASD 直径和 BOD 与已部署封堵器的大小。
33 例患者中，63.6%为女性，36.4%为男性，平均年龄为 18.07±14.58 岁（2-55 岁）。二维（2D）和三维（3D）超声心动图测量的 ASD 平均直径分别为 17.09±6.08mm 和 21.30±6.56mm，差异有统计学意义（ <0.001）。3D 超声心动图得出的 ASD 直径与封堵器大小的相关性明显高于 BOD 和 2D 超声心动图得出的直径（2D 超声心动图： = 0.796， <0.001，3D 超声心动图： = 0.960， <0.001，BOD： = 0.840， <0.001）。
3DTTE 可准确测量 ASD 直径，可作为选择封堵器大小的替代、有效且安全的方法。
