| Objective:To develop a novel double balloon catheter adapted for simple ultrasound-guided Percutaneous Balloon Pulmonary Valvuloplasty(PBPV).Methods:The novel catheter was developed to integrate the merits of traditional BALT balloon and Swan-Ganz balloon,with a guiding balloon on the distal end,the connecting catheter in the middle,and a working balloon on the proximal end.The feasibility of the novel catheter was verified by animal experiments.Results:Two animal experiments were carried out,each set with an experimental group using novel double-balloon catheters and a control group using BALT balloon catheters.In the first experiment,there were 5 healthy pigs in each group.The success rate was high and the incidence of complications was low in the experimental group,but it was found that the length of the connecting catheter was too long and the operation was time-consuming.Accordingly,the novel catheter was modified and determined as the final sample.In the second experiment,the sample size of animals was increased to 10 in each group.The success rate in the experimental group was significantly higher than that in the control group(100%vs 40%,P=0.011 and the operation time was shorter(7.3±1.8 min vs 26.7±9.lmin,P=0.000).The numbers of animal with balloon detachment,arrhythmia,myocardial hematoma or pulmonary artery injury in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion:The novel double balloon catheter is feasible for ultrasound-guided PBPV.Background:Percutaneous balloon pulmonary valvuloplasty(PBPV)is the procedure of choice for uncomplicated severe or symptomatic pulmonary stenosis.Echocardiography(echo)-guided PBPV can completely avoid the use of radiation and contrast agents comppared to fluoroscopy-guided PBPV.Although we have confirmed that echo-guided PBPV is feasible in humans,the poor visibility of the traditional catheter under echo greatly limits the promotion of this new technology.Methods:We produced a novel double-balloon catheter to make the catheter easy to be detected by echo through adding a guiding balloon at the distal end of the catheter.Echo-guided PBPV was performed on thirty healthy swine using either a novel catheter or a traditional catheter to evaluate the feasibility and safety of the novel double-balloon catheter.The feasibility was evaluated by the success rate of balloon inflation at the pulmonary valve annulus and the operating time.The safety was evaluated by the frequency of balloon slippage and the incidence of complications.Results:There were no significant between-group differences in terms of weight and the ratio of balloon diameter to pulmonary annulus diameter.The success rate was 93.3%and 60%in the novel and traditional groups,respectively.The novel group had significantly(P<0.05)lower mean procedure time(6.33±6.86 min vs 24.8±9.79 min)and lower frequency of balloon slippage(0.07±0.26 vs 0.53±0.52),arrhythmia(0.07±0.26 vs 0.47±0.52),and tricuspid regurgitation(6.7%vs 40%)than the traditional group.No myocardial haematoma or pericardial tamponade occurred in the novel catheter group.Conclusion:Although further studies and improvements are required,the study results indicate that the novel double-balloon catheter for echo-guided PBPV is feasible and safe.Objective:To assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect(ASD)guided by transthoracic echocardiography(TTE)in outpatients.Methods:From December 2016 to June 2018,50 patients underwent TTE-guided ASD transcatheter closure in the outpatient operating room of our hospital(a TTE group)including 22 males and 28 females at the age of 16?48(27.4±6.95)years.Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group,including 22 males and 28 females at the age of 15?48(28.58?6.96)years.Both groups were re-examined by TTE during follow-up at lmonth,3months,6 months and 1 year.Results:The mean age,body weight,the size of atrial septal defect and occluder and success rate had no statistical difference between the two groups(P>0.05).Compared with the control group,the TTE group had significantly lower mean operation time(P<0.01)and less cost(P<0.01)since patients need not to be hospitalized.No related complications were found in the TTE group during follow-up.Conclusion:Percutaneous transcatheter closure of atrial septal defect guided by TTE appears safe and effective in outpatients,and can significantly reduce the cost. |
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