PMID- 18642771
OWN - NLM
STAT- MEDLINE
DCOM- 20081222
LR  - 20161124
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 88
IP  - 10
DP  - 2008 Mar 11
TI  - [Application of transesophageal echocardiography in intraoperative device closure 
      of secundum atrial septal defects].
PG  - 691-3
AB  - OBJECTIVE: To evaluate the clinical value of transesophageal echocardiography 
      (TEE) in guiding intraoperative device closure of secundum atrial septal defect 
      (ASD). METHODS: Fifty ASD patients, aged 40 +/- 18 (15-72), 34 with an ASD 
      ranging from 30 to 40 mm and 16 with atrial septal aneurysm accompanied by double 
      or more ASDs, underwent intraoperative device closure through a right 
      minithoracotomy without cardiopulmonary bypass and fluoroscopy. Under general 
      anesthesia, a probe was inserted into the esophagus, and TEE was conducted at 
      different planes to observe the characteristics of the ASD. The size of implanted 
      device was determined by TEE. Small parasternal incision was made in the right 
      third or fourth intercostal space. A specially designed plastic sheath loaded 
      with Amplatzer occlusion device was inserted through the purse-string sutures 
      placed on the right atrium. Guided by transesophageal echocardiography, the 
      Amplatzer occlusion device was advanced through the ASD into the left atrium and 
      was deployed in place. The right ventricular end diastolic volume (RVEDV), right 
      ventricular end systolic volume (RVESV), right ventricular stroke volume (RVSV), 
      right ventricular ejection fraction (RVSV), left ventricular end diastolic volume 
      (LVEDV), left ventricular end systolic volume (LVESV), left ventricular stroke 
      volume (LVSV), and left ventricular ejection fraction (LVEF) before and after the 
      operation were calculated. RESULTS: The procedure was successful conducted in 48 
      patients. And the other two patients failing to receive this procedure, one 
      having a large ASD that could not be occluded and the other with ASD accompanied 
      by partial anomalous pulmonary venous connection, were shifted to operation with 
      cardiopulmonary bypass. After the operation, the RVEDV was (94 +/- 32) ml, and 
      the RVSV was (52 +/- 20) ml respectively, both significantly lower than those 
      before the operation [(78 +/- 23) ml and (41 +/- 13) ml respectively, both P < 
      0.05]. The LVEDV and LVSV after operation were (73 +/- 19) ml and (50 +/- 11) ml 
      respectively, both significantly higher than those before operation [(56 +/- 14) 
      ml and (34 +/- 12) ml respectively, both P < 0.05]. CONCLUSION: TEE provides 
      valuable information in further confirmation of diagnosis of ASD, selection of 
      appropriate size of Amplatzer occluder, guidance of the deployment of occluder, 
      observation of the effects of operation, and prompt detection of complication.
FAU - Zhang, Li-Hua
AU  - Zhang LH
AD  - Institute of Biomedical Engineering, Anzhen Hospital, Capital Medical University, 
      Beijing 100029, China.
FAU - Li, Zhi-An
AU  - Li ZA
FAU - Lin, Chang-Yan
AU  - Lin CY
FAU - Zhang, Chun
AU  - Zhang C
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Catheterization/*methods
MH  - Echocardiography, Transesophageal/*methods
MH  - Female
MH  - Heart Septal Defects, Atrial/*diagnostic imaging/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2008/07/23 09:00
MHDA- 2008/12/23 09:00
CRDT- 2008/07/23 09:00
PHST- 2008/07/23 09:00 [pubmed]
PHST- 2008/12/23 09:00 [medline]
PHST- 2008/07/23 09:00 [entrez]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2008 Mar 11;88(10):691-3.