This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ewert, P. Articles by Lange, P. E. Search for Related Content PubMed PubMed Citation Articles by Ewert, P. Articles by Lange, P. E. Related Collections Cardiovascular imaging agents/Techniques Other Treatment Echocardiography Pediatric and congenital heart disease, including cardiovascular surgery

(Circulation. 2000;101:847.)
© 2000 American Heart Association, Inc.

Brief Rapid Communications

Transcatheter Closure of Atrial Septal Defects Without Fluoroscopy

Feasibility of a New Method

Peter Ewert, MD; Felix Berger, MD; Ingo Daehnert, MD; John van Wees, MD; Matthias Gittermann, MD; Hashim Abdul-Khaliq, MD; Peter E. Lange, MD, PhD

From Abteilung für angeborene Herzfehler, Deutsches Herzzentrum Berlin, Germany.

Correspondence to Peter Ewert, MD, Abt. für Angeborene Herzfehler, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail ewert{at}dhzb.de

Background—In an effort to reduce x-ray exposure, we developed a technique for transcatheter closure of atrial septal defects under echocardiographic guidance without fluoroscopy. To assess the efficiency of this procedure for routine use, we compared our initial results with those for the conventional procedure.

Methods and Results—Twenty-two randomly selected patients (median age 18 years; range 2 to 66 years) with atrial septal defects (n=13) or patent foramen ovale (n=9) underwent cardiac catheterization for possible interventional defect closure with echocardiography as the only imaging tool. Median stretched diameter was 9 mm (range 6 to 26 mm); median left-to-right shunt over the atrial septal defects was Qp/Qs=1.8 (range 1.5 to 2.6). An Amplatzer septal occluder was successfully implanted in 19 defects without fluoroscopy and in 3 with the help of radiography. After 1 month, complete defect closure was documented in all patients. Compared with the conventional procedure of a control group of 131 patients, procedure times were not significantly different (88 versus 100 minutes; P=0.09). However, the study group received significantly higher doses of propofol for sedation (9.9 versus 5.6 mg/kg body weight; P=0.002) owing to extended transesophageal echocardiography.

Conclusions—In the majority of patients in whom transcatheter closure of interatrial communications with the Amplatzer septal occluder is possible, the procedure can be safely performed under echocardiographic guidance without fluoroscopy.

Key Words: heart septal defects • catheterization • echocardiography

This article has been cited by other articles:

				M R M Jongbloed, M J Schalij, K Zeppenfeld, P V Oemrawsingh, E E van der Wall, and J J Bax Clinical applications of intracardiac echocardiography in interventional procedures Heart, July 1, 2005; 91(7): 981 - 990. [Full Text] [PDF]

				G. Wimmer-Greinecker, S. Dogan, T. Aybek, M. F. Khan, S. Mierdl, C. Byhahn, and A. Moritz Totally endoscopic atrial septal repair in adults with computer-enhanced telemanipulation J. Thorac. Cardiovasc. Surg., August 1, 2003; 126(2): 465 - 468. [Abstract] [Full Text] [PDF]

				S.-M. Lin, S.-K. Tsai, J.-K. Wang, Y.-Y. Han, W.-h. Jean, and Y.-C. Yeh Supplementing Transesophageal Echocardiography with Transthoracic Echocardiography for Monitoring Transcatheter Closure of Atrial Septal Defects with Attenuated Anterior Rim: A Case Series Anesth. Analg., June 1, 2003; 96(6): 1584 - 1588. [Abstract] [Full Text] [PDF]

				A. Buecker, E. Spuentrup, R. Grabitz, F. Freudenthal, E. G. Muehler, T. Schaeffter, J. J. van Vaals, and R. W. Gunther Magnetic Resonance-Guided Placement of Atrial Septal Closure Device in Animal Model of Patent Foramen Ovale Circulation, July 23, 2002; 106(4): 511 - 515. [Abstract] [Full Text] [PDF]

				Z.-D. Du, Z. M. Hijazi, C. S. Kleinman, N. H. Silverman, K. Larntz, and Amplatzer Investigators Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: Results of a multicenter nonrandomized trial J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1836 - 1844. [Abstract] [Full Text] [PDF]

				E. J. Schaefer, J. R. McNamara, P. K. Shah, K. Nakajima, L. A. Cupples, J. M. Ordovas, and P. W.F. Wilson Elevated Remnant-Like Particle Cholesterol and Triglyceride Levels in Diabetic Men and Women in the Framingham Offspring Study Diabetes Care, June 1, 2002; 25(6): 989 - 994. [Abstract] [Full Text] [PDF]

				L. Torracca, G. Ismeno, and O. Alfieri Totally endoscopic computer-enhanced atrial septal defect closure in six patients Ann. Thorac. Surg., October 1, 2001; 72(4): 1354 - 1357. [Abstract] [Full Text] [PDF]

				J M Strotmann, W Voelker, and P Schanzenbaecher Persistence of the eustachian valve in secundum atrial septal defects: possible implications for cerebral embolism and transcatheter closure procedures Heart, July 1, 2001; 86(1): e5 - 5. [Abstract] [Full Text] [PDF]