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Updated: Aug 25, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
A prospective study of various anesthetic techniques in patients with acyanotic congenital heart diseases undergoing
Nidhi Sultania1, Tejaswini C Jambotkar2, Shakuntala N Basantwani1
1Consultant Anesthesiologist, Jai Hind Healthcare Hospital, Haryana, India.
Insights
Anesthetic techniques for transcatheter device closure of congenital heart defects (CHD) vary. General anesthesia with an endotracheal tube is preferred for patent ductus arteriosus and ventricular septal defects, while supraglottic airway devices may be suitable for atrial septal defects without TEE.
Area of Science:
- Cardiology
- Anesthesiology
- Pediatric Medicine
Background:
- Transcatheter device closure is increasingly used for congenital heart defects (CHD).
- Optimal anesthetic management for these procedures remains under-investigated.
- This study examines anesthetic techniques and their impact on hemodynamics and complications.
Purpose of the Study:
- To evaluate perioperative anesthetic management in patients undergoing transcatheter device closure of CHD.
- To assess the effects of different anesthetic techniques on hemodynamic parameters.
- To determine the complication rates associated with various anesthetic approaches.
Main Methods:
- Prospective observational study including patients aged 1 month to 50 years with acyanotic CHD.
- Anesthesia techniques recorded: general anesthesia with endotracheal tube (GETA)/supraglottic airway device (SGD) or conscious sedation with face mask (S-FM).
- Intraoperative vital signs, transesophageal echocardiography (TEE) use, and complications were documented.
Main Results:
- GETA was most common for patent ductus arteriosus (PDA) and ventricular septal defects (VSD).
- Propofol was the predominant induction agent (69.39%).
- Complications included SGD dislodgement, supraventricular tachycardia, and device dislodgements.
Conclusions:
- General anesthesia with an endotracheal tube is recommended for PDA and VSD device closure.
- General anesthesia with a supraglottic airway device may be suitable for atrial septal defect (ASD) closure in patients not requiring TEE.
- Anesthetic choices should be tailored to the specific defect and procedural requirements.
Background And Aims:
Transcatheter device closure of congenital heart defects (CHD) has recently gained popularity. As limited literature exists regarding the ideal anesthetic technique for these procedures, we studied the perioperative anesthetic management and its effects on hemodynamics and complication rate in patients undergoing device closure.
Methods:
In this prospective observational study, all patients of 1 month to 50 years of age with acyanotic congenital heart diseases undergoing device closure were included. The anesthesia technique, i.e., general anesthesia with endotracheal tube (GETA)/supraglottic airway device (SGD) or conscious sedation with face mask (S-FM), and intravenous induction agent used was noted. Intraoperatively vital parameters, use of transesophageal echocardiography (TEE), and perioperative complications if any, were noted. Descriptive statistical analysis was done using a statistical package for the social sciences (SPSS) version 15.
Results:
GETA was used in the atrial septal defect (ASD) (62.8%), patent ductus arteriosus (PDA) (66.7%), ventricular septal defect (VSD) (65%) patients, SGD in ASD (6.3%), PDA (16.7%), and VSD (13.3%) patients. S-FM in ASD (31.3%), PDA (16.7%) and VSD (21.7%) patients. Etomidate was used as an induction agent in 30.61% of the patients and propofol in 69.39% of the patients. The mean arterial pressure (MAP) in the etomidate and propofol groups was statistically insignificant while decreased heart rate was noted in both groups. Complications like SGD dislodgement, supraventricular tachycardia, and device dislodgements were seen.
Conclusion:
In PDA device closure patients, GETA should be preferred. Patients for VSD device closure should receive general anesthesia as complications are common. In ASD device closure, patients without TEE use can be done under general anesthesia with SGD.
