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Echocardiographic guidance of percutaneous patent foramen ovale closure: head-to-head comparison of transesophageal versus rotational intracardiac echocardiography.
Vigna, Carlo; Marchese, Nicola; Zanchetta, Mario; Chessa, Massimo; Inchingolo, Vincenzo; Pacilli, Michele Antonio; Amico, Cesare; Fanelli, Mario; Fanelli, Raffaele; Loperfido, Francesco.
Afiliação
  • Vigna C; Department of Cardiology, Casa Sollievo della Sofferenza Hospital IRCCS, San Giovanni Rotondo, Italy. carlovigna@libero.it
Echocardiography ; 29(9): 1103-10, 2012 Oct.
Article em En | MEDLINE | ID: mdl-22672292
ABSTRACT

BACKGROUND:

Transesophageal (TEE) and intracardiac (ICE) echocardiography are commonly used to guide percutaneous patent foramen ovale (PFO) closure. The study aim was to perform a head-to-head comparison between TEE and rotational ICE echocardiography in the measurement of the fossa ovalis and device selection.

METHODS:

In 45 patients with cryptogenic stroke or peripheral embolism and PFO with large right-to-left shunt, fossa ovalis dimensions were assessed preoperatively by TEE and intraoperatively by rotational ICE. The Amplatzer devices, deployed on the basis of ICE, were compared with those that would have been selected by TEE.

RESULTS:

A good correlation between TEE and rotational ICE was observed for both longitudinal and transverse fossa ovalis dimensions (TEE four-chamber vs. ICE four-chamber r = 0.75; TEE bicaval vs. ICE four-chamber r = 0.77; TEE aorta vs. ICE aorta r = 0.59; P < 0.001 for all). However, no such correlation was found in 13 patients with atrial septal aneurysm (ASA) (TEE four-chamber vs. ICE four-chamber r = 0.33; TEE bicaval vs. ICE four-chamber r = 0.49; TEE aorta vs. ICE aorta r = 0.05; P = NS for all). At Bland-Altman analysis, slight systematic differences with wide limits of agreement for each comparison were observed, particularly in patients with ASA, suggesting that the two imaging modalities cannot be used interchangeably. As regards device selection, a moderate agreement was found between TEE- and ICE-guided device size (72%, κ = 0.53, P < 0.001), except in patients with ASA (36%, κ = 0.02, P = NS).

CONCLUSIONS:

Our study suggests a significant disagreement between TEE and rotational ICE in measuring fossa ovalis and selecting the device for PFO closure, particularly in patients with ASA.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ecocardiografia Transesofagiana / Cirurgia Assistida por Computador / Forame Oval Patente / Técnicas de Imagem Cardíaca Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ecocardiografia Transesofagiana / Cirurgia Assistida por Computador / Forame Oval Patente / Técnicas de Imagem Cardíaca Tipo de estudo: Clinical_trials / Diagnostic_studies / Guideline Limite: Adult / Female / Humans / Male Idioma: En Ano de publicação: 2012 Tipo de documento: Article