Key result
Intracardiac echocardiography for sizing atrial septal defects correlated more strongly with balloon-stretched sizing plate measurements (r=0.963) than TEE (r=0.912), angiography, or TTE.
Why the study?
Does intracardiac echocardiography (ICE) provide more accurate sizing of atrial septal defects compared to TEE, TTE, and angiography during transcatheter closure?
Observational (n=270)
Does intracardiac echocardiography (ICE) provide more accurate sizing of atrial septal defects compared to TEE, TTE, and angiography during transcatheter closure?
Effect estimate: r = 0.963
Intracardiac echocardiography provides highly accurate sizing of atrial septal defects during transcatheter closure, correlating better with balloon-stretched sizes than TEE, TTE, or angiography.
ICE may support ASD sizing during closure; leaves open whether it improves outcomes versus TEE in randomized trials.
BACKGROUND: Transcatheter closure of a secundum atrial septal defect (ASD) has become an effective method for surgical treatment. In this study, we evaluated the feasibility and accuracy of intracardiac echocardiography (ICE) for sizing ASDs compared with conventional methods. METHODS: Between January 2004 and December 2006, 270 patients underwent transcatheter closure of secundum ASD by using septal occluders. For 142 patients, the procedure was guided by transesophageal echocardiography (TEE), and for 128 patients by ICE. We compared the maximal diameters of the ASDs obtained during angiocardiography, transthoracic echocardiography (TTE), ICE, and TEE with balloon-stretched sizes ascertained by using a sizing plate. RESULTS: ASD diameters measured with the sizing plate were significantly correlated with those measured with ICE (r = 0.963), TEE (r = 0.912), angiography (r = 0.88), and TTE (r = 0.85). The predicted stretched diameter of the ASDs, i.e. (nonstretched diameter measured with ICE x 1.07) + 3.23 mm, agreed well with that measured by using a sizing plate (Ri = 0.974). CONCLUSION: ASD diameters measured with ICE correlated with sizing-plate measurements better than those determined with TEE, angiography or TTE.
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Chien et al. (2008) conducted an observational in Secundum atrial septal defect (n=270). Intracardiac echocardiography (ICE) vs. Transesophageal echocardiography (TEE), angiography, and transthoracic echocardiography (TTE) was evaluated on Correlation of measured ASD diameters with balloon-stretched sizes using a sizing plate (r = 0.963). Intracardiac echocardiography for sizing atrial septal defects correlated more strongly with balloon-stretched sizing plate measurements (r=0.963) than TEE (r=0.912), angiography, or TTE.
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