Early follow-up results of simple transesophageal echocardiography to guide the right jugular internal vein for closure of atrial septal defect

Abstract

Objective To summarize the preliminary experience and early-stage follow-up results of simple transesophageal echocardiography(TEE) to guide right jugular internal vein for closure of atrial septal defect (ASD), and to investigate its feasibility. Methods A total of 24 ASD patients(12 male, 12 female) treated by transcatheter ASD closure under solely guidance of TEE were summarized in Children Heart Center, People's Hospital of Zhengzhou University from February 2015 to February 2016.Mean age, body weight and average diameter of the 24 cases of ASD were 5-18 (12.4±5.6) years old, 16-60 (34.1±9.6) kg, 5-20 (11.0±2.5) mm, respectively.All patients were treated by right jugular internal vein transcatheter closure under solely guidance of TEE.The efficiency of imme-diate post-operation under TEE was estimated, and follow-ups were done at 24 hours, 1 month, 3, 6 and 12 months after the procedures by transthoracic echocardiography, X-ray examination and electrocardiogram. Results A total of 23 patients were treated successfully under solely guidance of TEE.The diameter of devices was (14.5±3.6) mm.The procedural time was(20.5±7.2) min.One patient who had 2 ASD was treated by traditional thoracic surgery, because the small ASD had 5 mm residual shunt after the procedures.There were 3 cases with trivial residual shunt after the procedures immediately.All patients could move at once after operation.The average follow-up time was(5.6±1.2) months.No patients suffered from residual shunt, occluder malposition, peripheral vascular injury, pericardial effusion or cardiac perforation during the follow-up. Conclusions For some selected patients, simple TEE guiding right jugular internal vein for closure of ASD is applicable.The method not only prevents injury from radiation, but also shortens the in-bed time and avoid the lower limbs braking, with good early-stage follow-up results are desirable. Key words: Atrial septal defect; Transesophageal echocardiography; Catheterization