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| Intervention treatment of secundum ASD complicated with other malformations under echocardiographic guidance in 428 patients |
| DENG Dong-an, HOU Chuan-ju, ZHU Xian-yang, HAN Xiu-min |
| General Hospital of Shenyang Army, Shenyang 110016, China |
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Abstract Objective: To evaluate indications, technical procedure and clinical efficacy of interventional treatment of secundum ASD complicated with other malformations under echocardiographic guidance. Methods: From October 1998 to October 2004, 428 patients with secundum ASD, 150 males, 278 females, at a mean age of (26.6±16.6)years(ranged from 2 to 30 years old) with a mean weight of (51.1±18.2)kg(ranged from 11 to 110kg) were studied. All ASD were central, including single-fenestrated ASD(n=416) and multi-fenestrated ASD(n=12). In addition to ASD, 70 patients accompanied with other malformations. These abnormities included pulmonary stenosis(n=14), pulmonary hypertension(n=11), mitral valve stenosis(n=3), supraventricular tachycardia(n=3), atrial fibrilation(n=14). Detecting frequencies of ultrasound instruments(CDFI) Toshiba 6000, Japan, and HP 1500, America) were 2.5MHz and 5.0MHz respectively. Diagnosis was determined with transthoracic echocardiography before the interventional procedure, which was performed under the support of transesophageal echocardiography in adult and transthoracic echocardiography in children less than 10 years old. Results: The maximum diameter of ASD was measured by the expanding balloon diameter under echocardiographic guidance, position and number was decided by transesophageal echocardiography or transthoracic echocardiography. Devices were successfully implanted into 425(99.3%) of the 428 patients. In addition to ASD occluder implantation, some patients underwent interventions of complicated malformations during the same catheterization. ASD closure procedure started under echocardiographic guidance till complicated malformations were cured. One or several devices were selected for closure of multi-fenestrated ASD based on defect diameter and distance measured by transesophageal echocardiography. In this group, all the malformations were successfully cured. Conclusion: Interventional treatment of ASD complicated with other abnormities under echocardiographic guidance is safe and effective.
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Received: 24 August 2005
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2006, Vol. 17 
