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Predictors of Successful Transcatheter Closure of Atrial Septal Defect by Cardiac Magnetic Resonance Imaging

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Abstract

The location, size, and rim of an atrial septal defect (ASD) are major determining factors for transcatheter closure. We compared the measurements of ASD size and the characteristics of atrial septal rim using cardiac magnetic resonance imaging (MRI) with those obtained using transesophageal echocardiography (TEE). Patients with an ASD that met established criteria were selected for evaluation by cardiac MRI and TEE. There were 66 patients who underwent both TEE and cardiac MRI. Bland–Altman comparative analysis was performed to demonstrate agreement between measurement of ASD by MRI and balloon sizing compared to measurement of ASD by TEE and balloon sizing. Twelve patients were excluded from transcatheter closure of ASD. TEE did not demonstrate an adequate measurement of the posterior inferior rim in 10 of 66 patients. Fifty-four patients underwent transcatheter closure using the Amplatzer septal occluder. Of these, 52 patients had successful closure (ASD measurements of 25.9 ± 5.6 mm using MRI and 21.9 ± 5.8 mm using TEE). The median device size was 28 mm (range, 11–38). Patients who had successful closure had a significantly smaller major axis of ASD and larger posterior inferior rim compared to those of patients who were excluded from the closure procedure. Cardiac MRI showed a better correlation of ASD diameter measurement to balloon sizing compared to TEE. We believe that the most important predictive factor for successful transcatheter closure of an ASD is an adequate posterior inferior rim, which is best visualized using cardiac MRI.

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References

  1. F Berger M Vogel V Alexi-Meskishvili et al. (1999) ArticleTitleComparison of results and complications of surgical and Amplatzer device closure of atrial septal defects. J Thorac Cardiovasc Surg 118 674–678 Occurrence Handle1:STN:280:DyaK1Mvjs1arsw%3D%3D Occurrence Handle10504632

    CAS  PubMed  Google Scholar 

  2. JM Bland DG Altman (1986) ArticleTitleStatistical for assessing agreement between two methods of clinical measurement. Lancet 1 307–310 Occurrence Handle1:STN:280:BimC3MjhvFc%3D Occurrence Handle2868172

    CAS  PubMed  Google Scholar 

  3. ZD Du ZM Hijazi CS Kleinman et al. (2002) ArticleTitleComparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults. J Am Coll Cardiol 39 1836–1844 Occurrence Handle10.1016/S0735-1097(02)01862-4 Occurrence Handle12039500

    Article  PubMed  Google Scholar 

  4. K Durongpisitkul J Soongswang D Laohaprasitiporn et al. (1999) ArticleTitleTranscatheter closure of atrial septal defects by Amplatzer septal occluder instead of open heart surgery. Siriraj Hosp Gaz 51 104–111

    Google Scholar 

  5. K Durongpisitkul J Soongswang D Laohaprasitiporn et al. (2000) ArticleTitleIntermediate term follow-up on transcatheter closure of atrial septal defects by Amplatzer septal occluder. J Med Assoc Thai 83 1045–1053

    Google Scholar 

  6. K Durongpisitkul J Soongswang D Laohaprasitiporn et al. (2002) ArticleTitleComparison of atrial septal defect closure using transcatheter closure and surgery. Pediatr Cardiol 23 36–40 Occurrence Handle10.1007/s00246-001-0010-6 Occurrence Handle1:STN:280:DC%2BD387ovVGhsg%3D%3D Occurrence Handle11922506

    Article  CAS  PubMed  Google Scholar 

  7. K Durongpisitkul NL Tang J Soongswang et al. (2002) ArticleTitleCardiac magnetic resonance imaging of atrial septal defect for transcatheter closure. J Med Assoc Thai 85 IssueIDsuppl II 658–665 Occurrence Handle12322838

    PubMed  Google Scholar 

  8. S Ferreira SY Ho RH Anderson (1992) ArticleTitleMorphological study of defects of the atrial septal within oval fossa: implication for transcatheter closure of left-to-right shunt. Br Heart J 67 316–320 Occurrence Handle1:STN:280:ByyD3c7otV0%3D Occurrence Handle1389707

    CAS  PubMed  Google Scholar 

  9. MA Gendreau WR Triner J Bartfield (1999) ArticleTitleComplications of transesophageal echocardiography in the emergency department. Am J Emergency Med 17 248–251 Occurrence Handle1:STN:280:DyaK1M3mvVajtg%3D%3D

    CAS  Google Scholar 

  10. Z Hijazi Z Wang Q Cao et al. (2001) ArticleTitleTranscatheter closure of atrial septal defects and patent foramen ovale under intracardiac echocardiographic guidance: feasibility and comparison with transesophageal echocardiography. Catheter Cardiovasc Intervent 52 194–199 Occurrence Handle10.1002/1522-726X(200102)52:2<194::AID-CCD1046>3.3.CO;2-W Occurrence Handle1:STN:280:DC%2BD3M3jt1yjug%3D%3D

    Article  CAS  Google Scholar 

  11. G Holmvang (1999) ArticleTitleA magnetic resonance imaging method for evaluating atrial septal defects. J Cardiovasc Magn Reson 1 59–64 Occurrence Handle1:STN:280:DC%2BD3MrgtFahsw%3D%3D Occurrence Handle11550342

    CAS  PubMed  Google Scholar 

  12. SL Jan B Hwang PI Lee et al. (2001) ArticleTitleIntracardiac ultrasound assessment of atrial septal defect: comparison with transthoracic echocardiographic, angiographic, and balloon sizing measurements. Cardiovasc Intervent Radiol 24 84–89 Occurrence Handle10.1007/s002700000397 Occurrence Handle1:STN:280:DC%2BD3Mzoslemtg%3D%3D Occurrence Handle11443391

    Article  CAS  PubMed  Google Scholar 

  13. A Lange M Walayat CM Turnbull et al. (1997) ArticleTitleAssessment of atrial septal defect morphology by transthoracic three dimensional echocardiography using standard gray scale and Doppler myocardial imaging techniques: comparison with magnetic resonance imaging and intraoperative findings. Heart 78 382–389 Occurrence Handle1:STN:280:DyaK1c%2FmvVSltQ%3D%3D Occurrence Handle9404256

    CAS  PubMed  Google Scholar 

  14. JH Lu TL Hsu B Hwang et al. (1998) ArticleTitleVisualization of secundum atrial septal defect using transthoracic three-dimensional echocardiography in children: implications for transcatheter closure. Echocardiography 15 651–660 Occurrence Handle11175095

    PubMed  Google Scholar 

  15. J Masura P Gavora A Formanek et al. (1997) ArticleTitleTranscatheter closure of secundum atrial septal defects using the new self-centering Amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn 42 388–393 Occurrence Handle10.1002/(SICI)1097-0304(199712)42:4<388::AID-CCD7>3.0.CO;2-7 Occurrence Handle1:STN:280:DyaK1c%2Fnt12itw%3D%3D Occurrence Handle9408617

    Article  CAS  PubMed  Google Scholar 

  16. U Mazic P Gavora J Masura (2001) ArticleTitleThe role of transesophageal echocardiography in transcatheter closure of secundum atrial septal defects by the Amplatzer septal occluder. Am Heart J 142 482–488 Occurrence Handle10.1067/mhj.2001.116770 Occurrence Handle1:STN:280:DC%2BD3Mvot1KhsQ%3D%3D Occurrence Handle11526362

    Article  CAS  PubMed  Google Scholar 

  17. JA Rousou DA Tighe JL Garb et al. (2000) ArticleTitleRisk of dysphagia after transesophageal echocardiography during cardiac operations. Ann Thorac Surg 69 486–489 Occurrence Handle10.1016/S0003-4975(99)01086-3 Occurrence Handle1:STN:280:DC%2BD3c7pslOgsA%3D%3D Occurrence Handle10735685

    Article  CAS  PubMed  Google Scholar 

  18. JS Shanewise AT Cheung S Aronson et al. (1999) ArticleTitleASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. J Am Soc Echocardiogr 12 884–900 Occurrence Handle1:STN:280:DyaK1Mvkt1elsw%3D%3D Occurrence Handle10511663

    CAS  PubMed  Google Scholar 

  19. AM Taylor RH Stables PA Poole-Wilson et al. (1999) ArticleTitleDefinitive clinical assessment of atrial septal defect by magnetic resonance imaging. J Cardiovasc Magn Reson 1 43–49 Occurrence Handle1:STN:280:DC%2BD3MrgtFaiuw%3D%3D Occurrence Handle11550340

    CAS  PubMed  Google Scholar 

  20. W Zhu QL Cao J Rhodes et al. (2000) ArticleTitleMeasurement of atrial septal defect size: a comparative study between three-dimensional transesophageal echocardiography and the standard balloon sizing methods. Pediatr Cardiol 21 465–469 Occurrence Handle10.1007/s002460010111 Occurrence Handle1:STN:280:DC%2BD3M%2Fnt1Wiug%3D%3D Occurrence Handle10982709

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Prannok Road, Bangkok, Thailand 10700

    K. Durongpisitkul, J. Soongswang, D. Laohaprasitiporn & A. Nanal

  2. Philips Medical System, Faculty of Medicine Siriraj Hospital, Mahidol University, Prannok Road, Bangkok, Thailand 10700

    N. L. Tang

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  1. K. Durongpisitkul
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  2. N. L. Tang
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  3. J. Soongswang
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  4. D. Laohaprasitiporn
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  5. A. Nanal
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Correspondence to K. Durongpisitkul.

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Durongpisitkul, K., Tang, N., Soongswang, J. et al. Predictors of Successful Transcatheter Closure of Atrial Septal Defect by Cardiac Magnetic Resonance Imaging . Pediatr Cardiol 25, 124–130 (2004). https://doi.org/10.1007/s00246-003-0481-8

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