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Percutaneous Transcatheter Closure of Congenital Atrial Septal Defectwith Scoliosis under Transthoracic Echocardiography Guidance 认领 引用
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作者 Yaqi Tang Gang Luo +2 位作者 Huashu Liu Hao Wan Silin Pan 《Congenital Heart Disease》 SCIE 2025年第2期195-200,共6页
Congenital atrial septal defect(ASD)with severe scoliosis is a rare compound malformation inchildren.Severe sco liosis should be corrected as soon as possible.The growth rod is suitable for patients withearly scoliosi... Congenital atrial septal defect(ASD)with severe scoliosis is a rare compound malformation inchildren.Severe sco liosis should be corrected as soon as possible.The growth rod is suitable for patients withearly scoliosis and obvious scoliosis under 10 years old.However,the fluoroscopic radiopaque of titaniumalloy plate will inevitably partly make the operative field of interventional occlusion blind.We presenta7-year-old Chinese girl with ASD and scoliosis who underwent spinal correction with a dual-growthrod.In this case,we performed transcatheter closure of ASD solely under the guidance of transthoracicechocardiography.Transthoracic echocardiography(TTE)has been reported as efficacious and safe forassessment and guidance of ASD occlusion.For patients with visual field occlusion under fluoroscopy,theapplication of TTE is efficacious and safe for assessmnent and guidance of ASD occlusion. 展开更多
关键词 Atrial septal defect scoliosis transthoracic echocardiography in tervention closure child
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Comparative Clinical Outcomes of Right Lateral Thoracotomy and Totally Thoracoscopic Surgery for Adult Patients with Atrial Septal Defect:A Single Center,Retrospective Study 认领 引用
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作者 Yushen Fang Zechen Li +7 位作者 Jiahong Li Kaiyu Wang Gang Xu Shusheng Wen Jimei Chen Jian Zhuang Haiyun Yuan Xiaobing Liu 《Congenital Heart Disease》 SCIE 2025年第3期357-368,共12页
Background:Totally thoracoscopic surgery(TTS)and right lateral thoracotomy(RLT)are both extensively utilized in the surgical repair for atrial septal defect(ASD).However,RLT is generally considered in low-weight pedia... Background:Totally thoracoscopic surgery(TTS)and right lateral thoracotomy(RLT)are both extensively utilized in the surgical repair for atrial septal defect(ASD).However,RLT is generally considered in low-weight pediatric patients as a result of restricted surgical exposure.This study aims to introduce an RLT approach for ASD repair in adults and compare its clinical outcomes with TTS.Methods:We conducted a retrospective analysis of the clinical data of 23 adult patients who underwent ASD repair at Guangdong Provincial People’s Hospital between June and October 2024.Patients were divided into two groups based on the surgical approach they adopted:group totally thoracoscopic surgery(TTS,n=12)and group right lateral thoracotomy(RLT,n=11).All individuals finished a follow-up three months after surgery.Operative parameters,postoperative courses,echocardiographic measurements and laboratory investigations were compared between the two groups.Results:The total surgical duration was significantly longer in group RLT compared with group TTS[(234.00±47.93)min vs.(175.17±52.36)min,p=0.011].Group RLT exhibited a significantly higher respiratory index(RI)at<6 h postoperatively(1.00±0.58 vs.0.30±0.37,p=0.01)and significantly lower levels of soluble suppression of tumorigenicity 2(sST2)[(136.61±43.12)ng/mL vs.(199.08±33.56)ng/mL,p=0.037]and cardiac troponin(cTnT)[(277.04±89.85)pg/mL vs.(343.30±482.40)pg/mL,p=0.047]at 12-24 h postoperatively.Echocardiographic measurements showed no significant differences between two groups,except for a more pronounced reduction in left atrial(LA)size at discharge in group TTS[(5.00±3.64)mm vs.(0.09±4.44)mm,p=0.008].Conversely,group RLT demonstrated a less significant decrease in glutamyl transpeptidase(GGT)[(1.00±6.00)U/L vs.(5.25±3.86)U/L,p=0.026]but a more significant decrease in blood urea nitrogen(BUN)[(1.81±1.10)mg/dL vs.(0.81±1.07)mg/dL,p=0.038].Conclusions:RLT for ASD repair in adults demonstrated comparable clinical outcomes to TTS in terms of postoperative recovery and cardiac function and also produced fewer scars than TTS.Our study proved the feasibility,safety and cosmetic effects of uniport RLT for ASD repair in adults when compared with TTS. 展开更多
关键词 Atrial septal defect right lateral thoracotomy totally thoracoscopic surgery adult patient clinical outcome
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Transcatheter atrial septal defects and patent foramen ovale closure:Medicare utilization and reimbursements 认领 引用
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作者 Vidit Majmundar Rohan Deo +3 位作者 Ajay Kumar Mishra Peng-Yang Li Marina Byer Rhea Sancassani 《World Journal of Methodology》 2025年第4期225-231,共7页
BACKGROUND The Food and Drug Administration has approved percutaneous atrial septal defect(ASD)and patent foramen ovale(PFO)closure devices for hemodynamically significant interatrial shunts,paradoxical emboli includi... BACKGROUND The Food and Drug Administration has approved percutaneous atrial septal defect(ASD)and patent foramen ovale(PFO)closure devices for hemodynamically significant interatrial shunts,paradoxical emboli including stroke,and decompression sickness.We aimed to study the trends in utilization and reimbursements of transcatheter ASD/PFO closure devices.AIM To analyze trends in utilization and Medicare reimbursements for transcatheter ASD/PFO closure procedures from 2013 to 2022.METHODS A query of administrative data on United States Medicare beneficiaries undergoing transcatheter ASD/PFO was conducted from 2013 to 2022 using the Centers for Medicare and Medicaid Services Part B National Summary Data File.Inflation adjustments were made using the 2023 Consumer Price Index.Trend analysis was quantified using growth rate and simple linear regression calculations.All analyses were performed using Microsoft Excel 16.77.1(2023).RESULTS The annual number of transcatheter ASD/PFO closure procedures increased by 81%since 2013,with an average yearly growth rate of 44%cases per year(P<0.001).Annual Medicare reimbursements for transcatheter ASD/PFO therapies mirrored the annual procedure trends.The per-case reimbursements decreased by 18%,i.e.,$1128.80 in 2013 and$770.21 in 2022(P<0.001).There was a significant drop in the number of procedures in the year 2020,which correlates to the onset of the coronavirus disease 2019 pandemic,followed by a sharp uptick in the number of cases in 2021 and 2022.CONCLUSION Medicare utilization of transcatheter ASD/PFO closure therapies has grown significantly in procedural volume from 2013 to 2022.However,this has been accompanied by a decrease in per-case reimbursements. 展开更多
关键词 Atrial septal defect Patent foramen ovale Medicare Reimbursement Patent foramen ovale closure
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Completed atrioventricular block induced by atrial septal defect occluder unfolding:A case report 认领 引用 被引量:1
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作者 Chuan He Yang Zhou +2 位作者 Si-Si Tang Li-Hong Luo Kun Feng 《World Journal of Clinical Cases》 SCIE 2020年第22期5715-5721,共7页
BACKGROUND An atrial septal defect is a common condition and accounts for 25%of adult congenital heart diseases.Transcatheter occlusion is a widely used technique for the treatment of secondary aperture-type atrial se... BACKGROUND An atrial septal defect is a common condition and accounts for 25%of adult congenital heart diseases.Transcatheter occlusion is a widely used technique for the treatment of secondary aperture-type atrial septal defects(ASDs).CASE SUMMARY A 30-year-old female patient was diagnosed with ASD by transthoracic echocardiography(TTE)1 year ago.The electrocardiogram showed a heart rate of 88 beats per minute,normal sinus rhythm,and no change in the ST-T wave.After admission,TTE showed an atrial septal defect with a left-to-right shunt,aortic root short-axis section with an ASD diameter of 8 mm,a parasternal four-chamber section with an ASD diameter of 9 mm,and subxiphoid biatrial section with a diameter of 13 mm.Percutaneous occlusion was proposed.The intraoperative TTE scan showed that the atrial septal defect was oval in shape,was located near the root of the aorta,and had a maximum diameter of 13 mm.A 10-F sheath was placed in the right femoral vein,and a 0.035°hard guidewire was used to establish the transport track between the left pulmonary vein and the inferior vena cava.A shape-memory alloy atrial septal occluder with a waist diameter of 20 mm was placed successfully and located correctly.TTE showed that the double disk unfolded well and that the clamping of the atrial septum was smooth.Immediately after the disc was revealed,electrocardiograph monitoring showed that the ST interval of the inferior leads was prolonged,the P waves and QRS waves were separated,a junctional escape rhythm maintained the heart rate,and the blood pressure began to decrease.After removing the occluder,the elevation in the ST segment returned to normal immediately,and the sinus rhythm returned to average approximately 10 min later.After consulting the patient’s family,we finally decided to withdraw from the operation.CONCLUSION Compression of the small coronary artery,which provides an alternative blood supply to the atrioventricular nodule during the operation,leads to the emergence of a complete atrioventricular block. 展开更多
关键词 Completed atrioventricular block Atrial septal defect occluder Atrial septal defect Transthoracic echocardiography Case report
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A novel variant in TBX20 (p.DI76N) identified by whole-exome sequencing in combination with a congenital heart disease related gene filter is associated with familial atrial septal defect 认领 引用 被引量:11
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作者 Ji-jia LIU Liang-liang FAN +2 位作者 Jin-lan CHEN Zhi-ping TAN Yi-feng YANG 《Journal of Zhejiang University-SCIENCE B》 SCIE CAS CSCD 2014年第9期830-837,共8页
Congenital heart disease (CHD) is the leading cause of birth defects, and its etiology is not completely understood. Atrial septal defect (ASD) is one of the most common defects of CHD. Previous studies have demon... Congenital heart disease (CHD) is the leading cause of birth defects, and its etiology is not completely understood. Atrial septal defect (ASD) is one of the most common defects of CHD. Previous studies have demonstrated that mutations in the transcription factor T-box 20 (TBX20) contribute to congenital ASD. Whole-exome sequencing in combination with a CHD-related gene filter was used to detect a family of three generations with ASD. A novel TBX20 mutation, c.526G〉A (p.D176N), was identified and co-segregated in all affected members in this family. This mutation was predicted to be deleterious by bioinformatics programs (SIFT, Polyphen2, and MutationTaster). This mutation was also not presented in the current Single Nucleotide Polymorphism Database (dbSNP) or National Heart, Lung, and Blood Institute (NHLBI) Exome Sequencing Project (ESP). In conclusion, our finding expands the spectrum of TBX20 mutations and provides additional support that TBX20 plays important roles in cardiac development. Our study also provided a new and cost-effective analysis strategy for the genetic study in small CHD pedigree. 展开更多
关键词 Congenital heart disease (CHD) Atrial septal defect (ASD) Whole-exome sequencing CHD-relatedgene filter TBX20
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Usefulness of myocardial performance index for assessing right ventricular function after percutaneous closure of atrial septal defect 认领 引用 被引量:2
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作者 Jingdong Ding Genshan Ma +4 位作者 Yaoyao Huang Xiaoli Zhang Jian Zhu Rong Yang Fengxiang Lu 《Journal of Geriatric Cardiology》 CAS 2007年第4期220-224,共5页
Objective Assessment of right ventricular function in patients with atrial septal defect(ASD)is difficult.The Doppler myocardial performance index(MPI)may provide a method of assessing function in these patients.The p... Objective Assessment of right ventricular function in patients with atrial septal defect(ASD)is difficult.The Doppler myocardial performance index(MPI)may provide a method of assessing function in these patients.The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD.Methods MPI,defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time,was measured from tricuspid inflow and right ventricular outflow;Doppler velocity profiles recorded during routine echocardiography.Twenty nine patients(13 men,16 women;mean age 25.28±12.69,range 6 to 57 years)were diagnosed to secundum ASD[the stretched diameters of ASD were from 9 To 36(24.91±7.98)mm],and had a successfully placed Amplatzer septal occluder(ASO)(the sizes of ASO were from 11 to 40 mm);there were 81 sex-matched,age-matched healthy people(control group 41men,40 women;mean age 29.02±14.22,range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD.Change in the study group was assessed and compared to the control subjects with structurally normal hearts.A complete 2-dimensional and Doppler echocardiographic examination was performed in all study groups.Results 1)The isovolumic relaxation and isovolumic contraction times[respectively(77.59±14.39)ms vs(60.93±12.94)ms,P<0.0001;(28.28±10.88)ms vs(23.64±9.01)ms,P=0.027]were prolonged,and ejection time[(260.65±21.86)ms vs(271.85±21.92)ms,P=0.033]was shortened in patients with ASD compared with that in control subjects,resulting in a marked increase in the MPI(0.40±0.07 vs 0.31±0.05,P<0.0001)from normal values;2)by Pearson's correlations,the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD,but it correlated positively with age in patients with ASD;3)by Pearson's correlations,the MPI correlated positively with the diameter of ASD and pulmonary artery pressure;4)after transcatheter closure of ASD,the MPI decreased markedly.Conclusions 1)MPI is a conceptually new,simple,and reproducible Doppler index in patients with ASD;2)MPI is free from the effect of age,heart rate and blood pressure;(3)MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure;4)the right ventricular function was improved after transcatheter closure of ASD. 展开更多
关键词 heart atrial septal defect right ventricular function myocardial performance index
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The Role of Transesophageal Echocardiography for Transcatheter Closure of Atrial Septal Defects with the Amplatzer Septal Occluder 认领 引用 被引量:4
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作者 许迪 孔祥清 +3 位作者 杨荣 盛燕辉 曹克将 陆凤翔 《Journal of Nanjing Medical University》 2003年第3期110-115,共6页
Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age... Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty- two patients (10 to 55 years of age) were selected for percutaneous closure of ASD bytrans-esophageal echocardiography, which was also used to monitor the procedure, to select theappropriate size of the Amplatzer device, to verify its position, and to access the immediateresults of the procedure. During the follow-up, transthoracic echocardiography (TTE) or TEE was usedto evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiacchamber diameters. Results: The mean ASD diameter by TTE ([19. 1 +- 5. 8] mm) was significantlysmaller (P 0. 05). Due to proper patient selection all procedures were successful. There wasimmediate and complete closure in 61/62 patients, only one patients had trivial residual shunt.Follow- up was performed using TTE or TEE right after operation, 1 d, 1 month, 3 months, 6 monthsand yearly thereafter. Ail, patients remain asymptomatic without any clinical or technical problems.Conclusion: With the aid of TEE, percutaneous closure of ASD can be performed successfully, safely,and effectively. 展开更多
关键词 transesophageal echocardiography atrial septal defects amplatzer septaloccluder
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Perioperative anesthesia management in pediatric liver transplant recipient with atrial septal defect:A case report 认领 引用 被引量:2
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作者 Lan Liu Pei Chen +1 位作者 Li-Li Fang Li-Na Yu 《World Journal of Clinical Cases》 SCIE 2022年第29期10638-10646,共9页
BACKGROUND Preoperative conditions in pediatric liver transplant recipients are understandably complex.Compared with adults,children have lesser compensatory abilities and demand greater precision during procedural ex... BACKGROUND Preoperative conditions in pediatric liver transplant recipients are understandably complex.Compared with adults,children have lesser compensatory abilities and demand greater precision during procedural executions.In the setting of endstage liver disease,the heightened perioperative risk of coexistent cardiovascular pathology may impact graft survival as well.Requirements for anesthesia and perioperative management are thus more rigorous,calling for individualized treatments that reflect specific cardiovascular constraints and proposed surgical plans.CASE SUMMARY Reports of perioperative anesthesia management and liver transplant prognostication in pediatric patients with concurrent atrial septal defects are scarce.Herein,we detail the course of liver transplantation in a child with dual afflictions,focusing on perioperative anesthesia management and the important contributions of the anesthesiologist(pre-and perioperatively) to a positive therapeutic outcome,despite the clinical hurdles imposed.CONCLUSION Children with atrial septal defects bear substantially more than customary perioperative risk during orthotopic liver transplants,given their compromised cardiopulmonary reserves and functional states.Comprehensive preoperative cardiovascular assessments,including use of agitated-saline contrast echocardiography(to characterize intracardiac shunting) and multidisciplinary deliberation,may offer insights into structural cardiac pathophysiologic effects and transplantrelated hemodynamic changes that impact new grafts.At the same time,active and effective monitoring and other measures should be taken to maintain hemodynamic stability in the perioperative period,avoid entry of bubbles into the circulation,and ease congestion in newly grafted livers.Such efforts are crucial for transplantation success and graft survival. 展开更多
关键词 Pediatric liver transplant Atrial septal defect Anesthesia Case report
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Outcomes of Three Different Minimal Invasive Approaches for Secundum Atrial Septal Defect Closure: A Single Institute Experience 认领 引用 被引量:1
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作者 Hao HONG Long WU +2 位作者 Xiao-ke SHANG Wei SU Nian-guo DONG 《Current Medical Science》 SCIE CAS 2021年第6期1225-1230,共6页
Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical ... Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical data for transcatheter occlusion(TCO,n=63),transthoracic occlusion(TTO,n=55),and right anterolateral minithoracotomy(RALT,n=60)techniques used for ASD closure.We compared the safety and efficacy of the three approaches.Results:ASD size in the TTO group was similar to that in the RALT group(P=0.645)and significantly larger than that in the TCO group(P<O.OO1).The RALT group had more non-central types of ASD than the TTO and TCO groups(P=O.019 and P<O.OO1).The operative time in the TTO group was shorter than that in the TCO and RALT groups(P<O.OO1 and P<0.001).The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group(P<O.OO1 and P<O.OO1).Hospital duration in the TCO group was shorter than that in the TTO and RALT groups(P<O.OO1 and P<O.OO1).There were no residual shunt and mortality in any group in hospital or during follow-up.There was no significant difference in the incidence of total complications among the three groups(P=0.738).Conclusion:TCO,TTO,and RALT can be performed with favorable cosmetic and clinical results for closing ASD.Appropriate patient selection is an important factor for successful closure.These techniques are promising alternatives to standard median sternotomy and merit additional study. 展开更多
关键词 transcatheter occlusion transthoracic occlusion right anterolateral minithoracotomy secundum atrial septal defect
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Cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure: A case report 认领 引用 被引量:1
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作者 Yu-Cheng Wu Mei-Xiang Wang +2 位作者 Ge-Cai Chen Zhong-Bao Ruan Qing-Qing Zhang 《World Journal of Clinical Cases》 SCIE 2022年第12期3872-3878,共7页
BACKGROUND In patients who suffer from both atrial fibrillation(AF)and atrial septal defect(ASD),cryoballoon pulmonary vein isolation(PVI),sequential left atrial appendage(LAA)occlusion and ASD closure could be a stra... BACKGROUND In patients who suffer from both atrial fibrillation(AF)and atrial septal defect(ASD),cryoballoon pulmonary vein isolation(PVI),sequential left atrial appendage(LAA)occlusion and ASD closure could be a strategy for effective prevention of stroke and right heart failure.CASE SUMMARY A 65-year-old man was admitted to our institution due to recurrent episodes of palpitations and shortness of breath for 2 years,which had been worsening over the last 48 h.He had a history of AF,ASD,coronary heart disease with stent implantation and diabetes.Physical and laboratory examinations showed no abnormalities.The score of CHA2DS2VASc was 3,and HAS-BLED was 1.Echocardiography revealed a 25-mm secundum ASD.Pulmonary vein(PV)and LAA anatomy were assessed by cardiac computed tomography.PV mapping with 10-pole Lasso catheter was performed following ablation of all four PVs with complete PVI.Following the cryoballoon PVI,the patient underwent LAA occlusion under transesophageal echocardiographic monitoring.Lastly,a 34-mm JIYI ASD occlude device was implanted.A follow-up transesophageal echocardiography at 3 mo showed proper position of both devices and neither thrombi nor leakage was found.CONCLUSION Sequential cryoballoon PVI and LAA occlusion prior to ASD closure can be performed safely in AF patients with ASD. 展开更多
关键词 Atrial fibrillation Atrial septal defect Cryoballoon Pulmonary vein isolation Left atrial appendage occlusion Case report
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Evaluation of Atrial Septal Defect Using Real-time Three-dimensional Echocardiography:Comparison with Surgical Findings 认领 引用 被引量:2
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作者 Saumu Tobbi Mweri 邓又斌 +12 位作者 程佩萱 林汉华 王宏伟 Ommari Baaliy Mkangara 夏治 胡秀芬 毕小军 伍玉晗 Mustaafa Bapumiia 申屠伟慧 刘蓉 刘娅妮 朱美华 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2009年第2期257-259,共3页
The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical find... The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography (RT3DE) was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery (r=0.77, P〈0.001). The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes. 展开更多
关键词 real-time three-dimensional echocardiography atrial septal defect two dimensional echocardiography
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Clinical Value of Stereoscopic Three-dimensional Echocardiography in Assessment of Atrial Septal Defects: Feasibility and Efficiency 认领 引用 被引量:1
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作者 王静 王新房 +3 位作者 谢明星 贺林 吕清 王蕾 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2009年第6期791-794,共4页
Stereoscopic three-dimensional echocardiography(S-3DE) is a novel displaying technol-ogy based on real-time 3-dimensional echocardiography (RT-3DE). Our study was to evaluate the feasibility and efficiency of S-3D... Stereoscopic three-dimensional echocardiography(S-3DE) is a novel displaying technol-ogy based on real-time 3-dimensional echocardiography (RT-3DE). Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect (ASD) and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tis-sues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean formation time of the IVC, SVC were compared. Our results showed that S-3DE could measure the diameter of ASD accurately and there was no significant difference in the measurements between S-3DE and standard 3D display (2.89±0.73 cm vs 2.85±0.72 cm, P〉0.05; r=0.96, P〈0.05). The appearance of coronary sinus for S-3DE was higher as compared with the standard 3D display (93.3% vs 100%). The mean time of the IVC, SVC for S-3DE monitor was slightly shorter than that of the standard 3D display (11.0±3.8 s vs 10.3±3.6 s, P〉0.05). The mean completion time of interven-tional procedure was shortened with S-3DE display as compared with standard 3D display (17.3±3.1 min vs 23.0±3.9 min, P〈0.05). Stereoscopic three-dimensional echocardiography could improve the visualization of three-dimensional echocardiography, facilitate the identification of the adjacent structures, decrease the time required for interventional manipulation. It may be a feasible, safe, and efficient tool for guiding transcatheter septal occlusion or the surgical interventions. 展开更多
关键词 echocardiography stereoscopic vision real time three-dimension atrial septal defect occlusion
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Dynamic Characteristic Mechanism of Atrial Septal Defect Using Real-Time Three-Dimensional Echocardiography and Evaluation of Right Ventricular Functions 认领 引用 被引量:7
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作者 沙仁高娃 张军 +1 位作者 秦川 吕清 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 2017年第1期140-147,共8页
The dynamic characteristics of the area of the atrial septal defect(ASD) were evaluated using the technique of real-time three-dimensional echocardiography(RT 3DE), the potential factors responsible for the dynami... The dynamic characteristics of the area of the atrial septal defect(ASD) were evaluated using the technique of real-time three-dimensional echocardiography(RT 3DE), the potential factors responsible for the dynamic characteristics of the area of ASD were observed, and the overall and local volume and functions of the patients with ASD were measured. RT 3DE was performed on the 27 normal controls and 28 patients with ASD. Based on the three-dimensional data workstations, the area of ASD was measured at P wave vertex, R wave vertex, T wave starting point, and T wave terminal point and in the T-P section. The right atrial volume in the same time phase of the cardiac cycle and the motion displacement distance of the tricuspid annulus in the corresponding period were measured. The measured value of the area of ASD was analyzed. The changes in the right atrial volume and the motion displacement distance of the tricuspid annulus in the normal control group and the ASD group were compared. The right ventricular ejection fractions in the normal control group and the ASD group were compared using the RT 3DE long-axis eight-plane(LA 8-plane) method. Real-time three-dimensional volume imaging was performed in the normal control group and ASD group(n=30). The right ventricular inflow tract, outflow tract, cardiac apex muscular trabecula dilatation, end-systolic volume, overall dilatation, end-systolic volume, and appropriate local and overall ejection fractions in both two groups were measured with the four-dimensional right ventricular quantitative analysis method(4D RVQ) and compared. The overall right ventricular volume and the ejection fraction measured by the LA 8-plane method and 4D RVQ were subjected to a related analysis. Dynamic changes occurred to the area of ASD in the cardiac cycle. The rules for dynamic changes in the area of ASD and the rules for changes in the right atrial volume in the cardiac cycle were consistent. The maximum value of the changes in the right atrial volume occurred in the end-systolic period when the peak of the curve appeared. The minimum value of the changes occurred in the end-systolic period and was located at the lowest point of the volume variation curve. The area variation curve for ASD and the motion variation curve for the tricuspid annulus in the cardiac cycle were the same. The displacement of the tricuspid annulus exhibited directionality. The measured values of the area of ASD at P wave vertex, R wave vertex, T wave starting point, T wave terminal point and in the T-P section were properly correlated with the right atrial volume(P〈0.001). The area of ASD and the motion displacement distance of the tricuspid annulus were negatively correlated(P〈0.05). The right atrial volumes in the ASD group in the cardiac cycle in various time phases increased significantly as compared with those in the normal control group(P=0.0001). The motion displacement distance of the tricuspid annulus decreased significantly in the ASD group as compared with that in the normal control group(P=0.043). The right ventricular ejection fraction in the ASD group was lower than that in the normal control group(P=0.032). The ejection fraction of the cardiac apex trabecula of the ASD patients was significantly lower than the ejection fractions of the right ventricular outflow tract and inflow tract and overall ejection fraction. The difference was statistically significant(P=0.005). The right ventricular local and overall dilatation and end-systolic volumes in the ASD group increased significantly as compared with those in the normal control group(P=0.031). The a RVEF and the overall ejection fraction decreased in the ASD group as compared with those in the normal control group(P=0.0005). The dynamic changes in the area of ASD and the motion curves for the right atrial volume and tricuspid annulus have the same dynamic characteristics. RT 3DE can be used to accurately evaluate the local and overall volume and functions of the right ventricle. The local and overall volume loads of the right ventricle in the ASD patients increase significantly as compared with those of the normal people. The right ventricular cardiac apex and the overall systolic function decrease. 展开更多
关键词 ultrasonic cardiography real-time three-dimension atrial septal defect tricuspid annulus right atrium
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Should we consider patent foramen ovale and secundum atrial septal defect as different steps of a single anatomo-clinical continuum? 认领 引用 被引量:2
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作者 Gianluca Rigatelli 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2014年第3期177-179,共3页
1 Introduction Isolated atrial septal defects (ASD) represent 7% of all cardiac anomalies and can present at any age. Adolescents and adults with simple congenital heart disease such as isolated atrial septal defect... 1 Introduction Isolated atrial septal defects (ASD) represent 7% of all cardiac anomalies and can present at any age. Adolescents and adults with simple congenital heart disease such as isolated atrial septal defects are more likely to reach adult age without being diagnosed. Secundum ASD (sASD) is by far the most common type, occurring in 1/1500 live births, with 65% to 75% involving females, On the other hand, patent foramen ovale (PFO) represents an endemic variant in the normal population with a prevalence of 25%-27%. These two entities appear so different that is difficult to fred a conjunction ring: nevertheless we use the same philosophy for the treatment, Indeed, device-based closure has been proved to be effective in both settings. 展开更多
关键词 Anatomy Atrial septal defect Echocardiography Patent foramen ovale
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“Treat-Repair-Treat”:Management of Left Main Coronary Compression by a Pulmonary Artery Aneurysm in a Patient with Atrial Septal Defect and Significant Pulmonary Hypertension 认领 引用
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作者 Andrei George Iosifescu Roxana Enache +2 位作者 Ioana Marinică Corina Radu Vlad Anton Iliescu 《Congenital Heart Disease》 SCIE 2023年第1期67-72,共6页
Left main coronary compression syndrome(LMCS)may complicate pulmonary artery aneurysms(PAA),usually developed in the context of pulmonary arterial hypertension(PAH).We report the case of a 51-year-old female patient w... Left main coronary compression syndrome(LMCS)may complicate pulmonary artery aneurysms(PAA),usually developed in the context of pulmonary arterial hypertension(PAH).We report the case of a 51-year-old female patient with an atrial septal defect(unsuitable for device closure)complicated by a PAA generating a 90%left main stenosis.The significant PAH held us back from immediate surgery.After specific dual PAH-targeted therapy(sildenafil and bosentan),the atrial septal defect could be closed with a unidirectional valved patch;the PAAinduced LMCS was treated by reductive arterioplasty.The postoperative course was uneventful.Follow-up showed clinical improvement,but PAH treatment was still needed.After three months,coronary angiography showed only an insignificant residual left main stenosis,proving that reductive pulmonary arterioplasty was effective in treating LMCS.Any PAA requires further evaluation for LMCS,a dangerous but treatable complication.The“treat-repair-treat”strategy and shunt-closure with a unidirectional valved patch can both improve surgical prospects of LMCS with shunt-related PAH. 展开更多
关键词 Atrial septal defect pulmonary arterial hypertension pulmonary artery aneurysm left main coronary compression syndrome surgery unidirectional valved patch
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Intelligent diagnosis of atrial septal defect in children using echocardiography with deep learning 认领 引用
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作者 Yiman LIU Size HOU +7 位作者 Xiaoxiang HAN Tongtong LIANG Menghan HU Xin WANG Wei GU Yuqi ZHANG Qingli LI Jiangang CHEN 《虚拟现实与智能硬件(中英文)》 EI 2024年第3期217-225,共9页
Background Atrial septal defect(ASD)is one of the most common congenital heart diseases.The diagnosis of ASD via transthoracic echocardiography is subjective and time-consuming.Methods The objective of this study was ... Background Atrial septal defect(ASD)is one of the most common congenital heart diseases.The diagnosis of ASD via transthoracic echocardiography is subjective and time-consuming.Methods The objective of this study was to evaluate the feasibility and accuracy of automatic detection of ASD in children based on color Doppler echocardiographic static images using end-to-end convolutional neural networks.The proposed depthwise separable convolution model identifies ASDs with static color Doppler images in a standard view.Among the standard views,we selected two echocardiographic views,i.e.,the subcostal sagittal view of the atrium septum and the low parasternal four-chamber view.The developed ASD detection system was validated using a training set consisting of 396 echocardiographic images corresponding to 198 cases.Additionally,an independent test dataset of 112 images corresponding to 56 cases was used,including 101 cases with ASDs and 153 cases with normal hearts.Results The average area under the receiver operating characteristic curve,recall,precision,specificity,F1-score,and accuracy of the proposed ASD detection model were 91.99,80.00,82.22,87.50,79.57,and 83.04,respectively.Conclusions The proposed model can accurately and automatically identify ASD,providing a strong foundation for the intelligent diagnosis of congenital heart diseases. 展开更多
关键词 Deep learning Atrial septal defect Echocardiography
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Diagnostic chest X-ray in atrial septal defects 认领 引用
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作者 Gianluca Rigatelli Marco Zuin 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第2期125-125,共1页
A 66-year-old woman with lower limb edema and exertional dyspnea presented to the emergency department.Posteroanterior chest X-ray revealed a Fleischner’s sign in both lungs(Figure 1A)suggesting a pulmonary hypertens... A 66-year-old woman with lower limb edema and exertional dyspnea presented to the emergency department.Posteroanterior chest X-ray revealed a Fleischner’s sign in both lungs(Figure 1A)suggesting a pulmonary hypertension.A subsequent transthoracic echocardiogram revealed a 24 mm diameter secundum atrial septal defect(ASD)(Figure 1B)with a dilated right heart and a mean pulmonary pressure of 68 mmHg.Fleischner’s sign refers to a prominent central pulmonary artery that can be commonly caused either by pulmonary hypertension or acute pulmonary embolism.This radiological finding is very rare in patients with secundum ASD unless the defect remains undiagnosed till the elderly.Chest X-ray remains fundamental in making diagnosis of cardiovascular disease. 展开更多
关键词 Atrial septal defect Fleischner’s sign Pulmonary arterial hypertension
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Radiofrequency ablation of atrial tachycardia in patients with repaired atrial septal defect 认领 引用
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作者 胡建强 曹江 +1 位作者 秦永文 周炳炎 《Journal of Medical Colleges of PLA(China)》 2007年第2期121-124,共4页
Objective:To evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) in patients with repaired atrial septal defects(ASD). Methods: In 76 consecutive patients ... Objective:To evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) in patients with repaired atrial septal defects(ASD). Methods: In 76 consecutive patients with AT who underwent the electrophysiological study and radiofrequency catheter ablation (RFCA). 4 patients (one male and three female aged 35. 5±11. 5 years) had AT-related myocardial scar or incision. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results: Re-entry related to the lateral atriotomy scar was inducible in 3 of 4 patients. With en-trainment mapping, the PPI-TCL difference was <30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 2 patients had successful linear ablation between scar area to inferior vena cava, and 1 patient between scar areas to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 4 patients. PPI-TCL differences <30 ms were found when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of incision-related AT was found during follow-up except for the failed patient. Conclusion: Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation also can be obtained in patients with IRAT related to myocardial scar or incision. 展开更多
关键词 atrial tachycardia radiofrequency catheter ablation atrial septal defect
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Diagnostic value of real-time three-dimensional transesophageal echocardiography for preoperative assessment of sinus venosus atrial septal defect 认领 引用
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作者 郑智超 费洪文 +3 位作者 陈欧迪 朱伟 许燕 侯跃双 《South China Journal of Cardiology》 CAS 2014年第2期125-129,170,共5页
Background Sinus venosus atrial septal defect(SVASD) is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardi... Background Sinus venosus atrial septal defect(SVASD) is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardiography(2D-TTE) is certainly the initial choice of evaluation of SVASD but is unable to show its spatial relation to the surrounding structures and the configuration of the veins accurately. The purpose of this study was to evaluate the diagnostic accuracy of real-time three-dimensional transesophageal echocardiography(RT3D-TEE) for detecting SVASD and partial anomalous pulmonary venous connection(PAPVC). Methods2D-TTE and RT3D-TEE were performed in 25 patients with the SVASD before surgical repair. Records of these patients were compared with surgical assessments. Results Twenty-three of the 25 patients with SVASD were detected by 2D-TTE. All the 23 patents were associated with PAPVC. Two of the 25 patients with SVASD were misdiagnosed as the secundum atrial septal defect by 2D-TTE. SVASD was demonstrated in all the 25 cases by RT3D-TEE, and 25 patents were associated with PAPVC. Conclusions RT3D-TEE is highly accurate, scientific method for displaying the location, size, shape of the defect and its spatial relation to the surrounding structures, and provides additional value to the surgeon and physicians for better understanding of spatial intracardiac morphology and making more accurate diagnosis and treatment. 展开更多
关键词 echocardiography three-dimensional transesophageal sinus venosus atrial septal defect
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Transcatheter versus surgical closure of secundum atrial septal defects:a systematic review and meta-analysis 认领 引用
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作者 陈茜茜 张笃飞 +2 位作者 张湘云 林诗婷 王海凡 《South China Journal of Cardiology》 CAS 2023年第3期146-157,共12页
Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are common treatment methods.It is not clear which method has a more obvious technical advantage.Objective To summarise dat... Background Transcatheter closure and surgical closure of secundum atrial septal defects(SASDs)are common treatment methods.It is not clear which method has a more obvious technical advantage.Objective To summarise data from studies comparing transcatheter closure versus surgical closure of SASDs.Methods Databases including Pub Med,EMbase,Web of science,Cochrane Library,CBM,CNKI and Wanfang databases were searched to enroll randomized controlled trials and cohort study trials comparing the two treatment methods(transcatheter closure versus surgical closure).The literature was screened according to the inclusive and exclusive criteria by two reviewers independently.The quality of the trials was evaluated.The data were extracted and meta-analysis was performed using Rev Man 5.3 software.Results 29 original studies(14,941 patients)were included.All studies were non-random.Transcatheter closure was found to be superior to surgical closure in the following outcomes:all-cause mortality(OR 0.36,95%CI 0.21~0.59,P<0.0001),total complications(OR 0.37,95%CI 0.25~0.55,P<0.00001),and hospital stay length(WMD-3.77,95%CI-4.36~-3.18,P<0.00001).Residual shunts incidence and retreatment incidence were more common in the transcatheter closure group than those in the surgical closure group[(OR 3.55,95%CI 1.79~7.05,P=0.0003)and(OR 2.19,95%CI 1.31~3.65,P=0.003),respectively].Conclusions Both approaches are effective for closure SASDs.Transcatheter is associated with lower mortality,complications and hospital stay length,while surgical closure has incidence of residual shunting and retreatment. 展开更多
关键词 Transcatheter closure Surgical closure Atrial septal defect Meta-analysis
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