Saraç İbrahim, Birdal Oğuzhan
Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum 25010, Türkiye.
Department of Physiology, Faculty of Medicine, Atatürk University, Erzurum 25010, Türkiye.
Diagnostics (Basel). 2024 Aug 12;14(16):1755. doi: 10.3390/diagnostics14161755.
BACKGROUND/OBJECTIVES: To close the atrial septal defect (ASD) with the transcatheter method, correctly defining the defect and selecting the appropriate closure device size are the most critical steps for the procedure's success. Although ASD can be successfully closed under the guidance of three-dimensional (3D) transesophageal echocardiography (TEE) and two-dimensional (2D) TEE, measurement comparisons between different types of defects are still needed.
Our study was designed retrospectively. Sixty-one patients who underwent transcatheter ASD closure with 2D TEE and 3D TEE between 2020 and 2024 were included. The patients were divided into three groups according to the defect shape: circular, oval, and complex; and the measurement results, perioperative process, and clinical outcomes were compared in each group.
The average age of the patients was 35.05 ± 13.87 years, and 41 (67.2%) were women. The average follow-up period of the patients was 15.3 ± 9.18 months. No statistical significance was observed in the comparison of measurements obtained with 3D TEE and 2D TEE in the circular and oval defect groups. The differences between the minimum defect diameters of complex defects measured by 2D TEE and 3D TEE (: 0.037), IVC rims ( < 0.001), aortic rims (: 0.012), and the differences between implanted device dimensions and the maximum defect diameters measured by both methods were compared; statistical significance was observed (: 0.025).
In circular and non-complex oval defects, it has been observed that the size of the closure device selected with 2D TEE or 3D TEE is optimal, and the procedure is practical and feasible. While the closure of complex ASDs with 3D TEE provides reliable and optimal results, using only 2D TEE in complex ASDs may lead to selecting a smaller-sized device.
背景/目的：采用经导管方法闭合房间隔缺损（ASD）时，准确界定缺损并选择合适的封堵器尺寸是手术成功的关键步骤。尽管在三维（3D）经食管超声心动图（TEE）和二维（2D）TEE引导下可成功闭合ASD，但仍需比较不同类型缺损的测量结果。
本研究为回顾性设计。纳入2020年至2024年间采用2D TEE和3D TEE进行经导管ASD封堵的61例患者。根据缺损形状将患者分为三组：圆形、椭圆形和复杂形；并比较每组的测量结果、围手术期过程及临床结局。
患者平均年龄为35.05±13.87岁，女性41例（67.2%）。患者平均随访期为15.3±9.18个月。圆形和椭圆形缺损组中，3D TEE和2D TEE测量结果比较无统计学意义。比较了2D TEE和3D TEE测量的复杂缺损最小缺损直径之间的差异（：0.037）、下腔静脉边缘（<0.001）、主动脉边缘（：0.012），以及两种方法测量的植入装置尺寸与最大缺损直径之间的差异；观察到有统计学意义（：0.025）。
在圆形和非复杂椭圆形缺损中，观察到采用2D TEE或3D TEE选择的封堵器尺寸是最佳的，该手术实用且可行。虽然3D TEE闭合复杂ASD可提供可靠且最佳的结果，但在复杂ASD中仅使用2D TEE可能导致选择尺寸较小的装置。
