Title : 4D transesophageal echocardiography in transcatheter closure of atrial septal aneurysms
3DTEE is superior to 2DTEE as it provides all atrial septal information from a single view.
Aim: To evaluate 3DTEE role in atrial septal aneurysm (ASA) analysis & in its device closure guiding.
3DTEE were recorded with Vivid*E9,GE system over 14 months. ASAs were classified into 4 types (A:With PFO, B:With one ASD, C:With 2 ASDs & D:With multiple fenestrations). Each aneurysm was assessed according to its type, shape, dimensions, orientation, aneurysmal tissue and the surrounding rims. All patients underwent transcatheter closure of the aneurysm.
21 patients with ASAs were assessed (2 imperforated aneurysms excluded). The remained 19 patients’ age was 12.84±5.82years. Four patients had type A aneurysms, 6 had type B, 4 had type C and 5 had type D. 3DTEE demonstrated oval aneurysms in 17 patients. The orientation was oblique in 8 patients, vertical in 7 and horizontal in 4. The ASAs dimensions were 23.5±5.1mm, 23.2±5.1mm and 22.0±4.0mm for oblique, vertical and horizontal axes. Percutaneous closure succeeded in 18 patients. Balloon sizing was used in 4 patients. Devices used were: In type A:PFO devices, in type B:ASO devices, in type C:2 patients required two ASO devices in each patient and 2 patients required one cribriform device, and in type D:Cribriform devices used for 3 patients, PFO for one and ASO for one. LA, LUPV& RUPV approaches were used. All patients received aspirin for 6 months.
3DTEE helps to select aneurysms suitable for transcatheter closure, select the suitable devices and guide the transcatheter procedure.
Audience take away:
• The audiences will learn 4D transesophgeal echocardiography techniques, views and interpretation in assessment of atrial septal defects and aneurysms.
• This will help the echocardiographers to provide new information in analysis of the shape, the type and the character of the atrial septal aneurysms and the included defects.
• This protocol gives a practical solution to the problem of selection whether the atrial septal aneurysm is suitable for transcatheter closure or that it requires surgical intervention.
• This is also will help the interventionists to select the proper device type and size accurately to occlude the atrial septal aneurysm and to guide the transcatheter procedure with minimization of complications.
• Of course this research other faculties could use to expand their research and teaching.