The Study On The Safety And Feasibility Of Transthoracic Ultrasound-Guided Percutaneous Closure Of Atrial Septal Defect

Objective:To investigate the safety and feasibility of transthoracic ultrasound-guided atrial septal defect(ASD)closure.Methods:In March 2018 to February 2019 in Inner Mongolia medical university affiliated hospital cardiac vascular surgical line simply by thoracic echocardiography(TTE)guided percutaneous closure of 17 patients with secondary ASD alone,at the same time by our classic X-ray line(X-ray)guided by ASD closure in patients at TTE group technical success patient’s gender,ageand BMI level 1-1 match out of 13 cases as control group were retrospectively analyzed.Patients were divided into TTE group and X-ray group according to different guiding methods.Under local anesthesia or intravenous anesthesia,patients in TTE group underwent percutaneous closure of atrial septal defect guided by TTE.In the X-ray group,the atrial septal defect was occluded under local anesthesia or intravenous anesthesia with X-ray guidance.Immediately after the ASD was occluded with the occlusion umbrella,transthoracic echocardiography was used to check whether there was residual shunt and whether the shape of the occlusion umbrella was full and in an appropriate position.Ekg,chest X-ray and transthoracic echocardiography were reviewed in the outpatient department 1 month,3 months,6 months and 1 year after discharge to check the postoperative recovery.Results:In the TTE group,16 patients were successfully placed and blocked.Among them,1 patient was successfully blocked by X-ray due to relatively heavy weight and unclear development of acoustic window.Pericardial effusion occurred during the operation in 1 child patient,and pericardial puncture and drainage were performed in an emergency and then transferred to X-ray occlusion successfully.1 case was successfully blocked by X-ray due to unclear development of sound window.One patient failed to seal,and multiple chamber defects were found during the operation.After sealing,residual shunt of 4-7mm existed,and the occluder was removed.There were no statistically significant differences between the two groups in length of stay,ASD diameter,operation time,hospitalization cost,and length of stay in the intensive care unit(ICU)(P = > 0.05).No arrhythmia,peripheral vascular injury or other complications occurred in the two groups during hospitalization.Conclusion:TTE guided percutaneous interventional therapy for atrial septal defect can not only avoid X-ray injury,but also be safe,effective and feasible.