TEE Guided Technology Application In Intervention Closure ASD And VSD

Objective To explore the feasibility of transcatheter closure of atrial septal defect(ASD) and ventricular septal defect(VSD) guided simple transesophageal echocardiography(TEE).Methods We retrospectively analysied the clinical data of patients in Zhengzhou University people’s hospital who received transcatheter-closure of ASD and VSD from Nov.2013 to Feb.2016 guided only by TEE and summarized intraoperative procedure skills and operative details. Part 1:The feasibility transcatheter closure of ASD via femoral vein guided simple by TEE. Part 2:The feasibility transcatheter closure of ASD via internal jugular vein guided only by TEE. Part3:The feasibility transcatheter closure of VSD via femoral vein using retrograde intubation guided only by TEE.We compared the difference of multivariants including radiation time, x-ray dose, successful ratio, contrast agent dose, in-hospital complication, bedrest time, hospital-stay days, of two different procedures guided only TEE and by x-ray. And we disscussed the clinical application value of the method guided simple by TEE.Results1. 21 patients with ASD were successfully treated with transcatheter closure via femoral vein guided by TEE. no radioactive rays were used during procedures. Comparative differences with during same period 73 patients with ASD were treated with regular transcatheter closure via femoral vein guided by x-ray. There were no statistically difference in success ratio, procedure time, hospitalization time and compalications(p>0.05),when compared to two different methods guided only by TEE or by x-ray. 2. 24 patients with ASD were successfully treated with transcatheter closure via internal jugular vein guidede only by TEE in 25 cases. While operating on a child with two ASDs, alveolus failed to fully cover the residual 5mm separated flow, the procedure finally turned to a side-open repairing thoracotomy and achieved success. No radioactive rays were used during procedures. Comparative differences with during same period 73 patients with ASD were treated with regular transcatheter closure via femoral vein guided by x-ray. there are no statistically difference in success ratio, hospitalization time and compalications(p>0.05),when compared to two different methods guided only by TEE or by x-ray. but there are statistically difference in procedure time and bedrest time(p﹤0.05). 3. As to 14 patients with VSD were successful treated with transcatheter closure via femoral artery guided only by TEE, no radioactive rays and contrast agent were used during procedure. Comparative differences with during same period 15 patients with VSD were treated with regular transcatheter closure via femoral vein and femoral artery guided by x-ray. There were no statistically difference in success ratio, procedure time, hospitalization time and compalications(p>0.05),When compared to two different methods guided only by TEE or by x-ray.Conclusion1. Transcatheter closure of ASD and VSD is feasible guided only by TEE. Not only can it preserve the advantages of regular transcatheter closure of ASD and VSD guided by x-ray, but also avoid the damage caused by radioactive x-rays and contrast agent. With the advance in present equipment, it will have more application potentials.2. Transcatheter closure of ASD via internal jugular vein guided by TEE is accessible and safe, with shorter lying time and procedure time than control group.3. Transcatheter closure of VSD guided by TEE is safe, practicable and simple procedure like control group.