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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Transgastric: A forgotten view for atrial septal defect device closure procedures?
Clifford L Cua1, Amy L Cooper1, Marc Dutro1
1Nationwide Children's Hospital, Columbus, OH, USA.
Echocardiography (Mount Kisco, N.Y.)
|September 13, 2017
Summary
Transcatheter closure of atrial septal defects uses imaging guidance. Transgastric views offer unique insights into the atrial septal defect anatomy, particularly the inferior vena cava rim, aiding device deployment.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Percutaneous closure of atrial septal defects (ASDs) necessitates precise imaging for device selection and deployment.
- Transesophageal echocardiography (TEE) is the standard noninvasive imaging modality for ASD closure procedures.
- Current TEE guidelines for ASD closure do not incorporate transgastric views.
Observation:
- This case report highlights the utility of transgastric echocardiographic views during percutaneous ASD closure.
- Transgastric imaging provided specific anatomical details not fully appreciated with standard TEE views.
- Particular attention was given to the inferior vena cava (IVC) rim, crucial for device anchoring.
Findings:
- Transgastric views offer a complementary perspective for characterizing ASDs, especially concerning the IVC rim.
- This approach can enhance the assessment of anatomical suitability for device closure.
- The inferior vena cava rim is a critical landmark for successful device implantation.
Implications:
- Incorporating transgastric views into echocardiographic guidance may improve ASD closure procedural success.
- This technique could refine device selection and positioning, minimizing risks.
- Further research into the routine use of transgastric views in ASD closure is warranted.
