Abstract 13097: Feasibility and Safety of Trans-nasal Transesophageal Echocardiography Guiding Left Atrial Appendage Closure Without General Anesthesia

Abstract

Background: Percutaneous left atrial appendage closure (LAAO), may be an alternative therapy to non-valvular atrial fibrillation (AF) patients. And the transesophageal echocardiography (TEE) is the mainstay of the imaging technology to guide LAAO procedures. However, in the local anesthesia state, LAAO cannot be accomplished under the real-time guidance of conventional TEE with the standard adult TEE probe. The aim of the study was to explore the feasibility and safety of trans-nasal TEE with the microprobe to guide LAAO without general anesthesia. Methods: A total of 30 non-valvular AF participants were enrolled in the study. All participants both underwent conventional TEE examination with the standard adult TEE probe before LAAO, and the real-time guidance of trans-nasal TEE with the microprobe intraoperatively under local anesthesia. Results: There weren’t significant difficulties to insert the microprobe into the esophagus through the nares. All patients tolerated the trans-nasal approach well. Image quality by the microprobe was reviewed as good (67.3%) and acceptable (36.7%) by two different echocardiographers. The devices were successfully implanted in all participants. No observed significant residual peri-device leaks by the microprobe at the time of the procedure and by the standard TEE on a median of 55 days (interquartile range: 48 to 66 days) postoperatively. 2(7%) patients had mild epistaxis after the procedure, and there were no other severe complications. Conclusion: The present study preliminarily showed the feasibility and safety of the trans-nasal micro-TEE and suggested it may become an alternative to conventional TEE to guide LAAO procedure without general anesthesia.