[Efficacy of percutaneous atrial septal defect closure guided by transesophageal echocardiography in children]

Area of Science:

• Cardiology
• Pediatric Medicine
• Medical Imaging

Background:

• Atrial septal defect (ASD) is a common congenital heart defect.
• Percutaneous closure is a minimally invasive treatment option for ASD.
• Guidance methods for percutaneous ASD closure include transesophageal echocardiography (TEE) and fluoroscopy.

Purpose of the Study:

• To compare the efficacy of percutaneous ASD closure guided by TEE versus fluoroscopy in pediatric patients.
• To evaluate procedural success, operative time, and postoperative complications between the two guidance methods.

Main Methods:

• Retrospective review of medical records of pediatric patients who underwent percutaneous ASD closure between January 2017 and March 2018.
• 120 patients in the TEE group and 125 patients in the fluoroscopy group.
• Comparison of surgical performance, efficacy, and postoperative complications.

Main Results:

• Percutaneous ASD closure was successful in all patients.
• The TEE group had a shorter operation time (20±14 min) compared to the fluoroscopy group (29±11 min) (P<0.05).
• The TEE group had a larger defect size (11±4 mm) than the fluoroscopy group (9±4 mm) (P<0.05), with no significant differences in occluder or sheath sizes.
• No significant differences in postoperative complications such as residual shunt, occluder issues, arrhythmia, or pericardial effusion were observed between groups.

Conclusions:

• Percutaneous ASD closure guided by TEE or fluoroscopy yields similar outcomes.
• TEE guidance may reduce operative time and provide more accurate ASD size assessment.
• TEE guidance avoids radiation exposure and the need for contrast agents and specialized imaging equipment.