Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2019; 7(6): 734-741
Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.734
Successful totally transthoracic echocardiography guided transcatheter device closure of atrial septal defect in pregnant women
Qiang Chen, Hua Cao, Gui-Can Zhang, Liang-Wan Chen, Fan Xu
Qiang Chen, Hua Cao, Gui-Can Zhang, Liang-Wan Chen, Fan Xu, Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian Province, China
Author contributions: Chen Q and Cao H contributed equally to this study and are co-first authors; Chen Q and Cao H contributed to study conception and design; Zhang GC and Xu F contributed to data acquisition, analysis, and interpretation, and writing of the article; Chen Q, Cao H, Zhang GC, Chen LW, and Xu F contributed to the editing and final approval of the article.
Supported by Chinese National and Fujian Provincial Key Clinical Specialty Construction Programs.
Institutional review board statement: The present study was approved by the Ethics Committee of Fujian Medical University, China and adhered to the tenets of the Declaration of Helsinki.
Informed consent statement: All patients were counseled on the potential maternal and fetal risks associated with the pregnancy, and all signed a consent form to undergo transcatheter device closure of ASD.
Conflict-of-interest statement: None.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qiang Chen, MD, Doctor, Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. chenqiang2228@163.com
Telephone: +86-591-83344034
Received: December 20, 2018
Peer-review started: December 20, 2018
First decision: January 19, 2019
Revised: February 1, 2019
Accepted: February 18, 2019
Article in press: February 18, 2019
Published online: March 26, 2019
Abstract
BACKGROUND

Transcatheter device closure of atrial septal defect (ASD) guided by fluoroscopy and/or transesophageal echocardiography is a mature technology. Little study has focused on whether the technology can be guided totally by transthoracic echocardiography (TTE), even in pregnant women with ASD.

AIM

To evaluate the safety and efficacy of totally TTE guided transcatheter device closure of ASD in pregnant women.

METHODS

Six pregnant women (gestational age 20-26 wk) with ASD underwent transcatheter device closure totally guided by TTE at our cardiac center from January 2015 to August 2017. A routine transcatheter procedure without fluoroscopy or intubation and a domestic occluder were used in this study.

RESULTS

All patients had successful closure with good clinical results, and the overall immediate complete closure rate was 100%. The size of the occluder deployed ranged from 20 to 32 mm (26.7 ± 4.3 mm), the procedure time ranged from 30 to 50 min (41.7 ± 7.5 min), and the length of hospital stay was 2-3 d (mean 2.2 ± 0.4 d). There were no serious cardiovascular related complications, and transient arrhythmias occurred in one patient during the procedure. During the follow-up period (3 mo to 2 years), no occluder dislodgement, residual fistulas, or thromboses occurred. All of the patients underwent vaginal delivery between 36 and 38 wk of gestation.

CONCLUSION

Totally TTE guided transcatheter device closure of ASD in pregnant women may be safe and effective.

Keywords: Congenital heart disease, Septal defects, Cardiac intervention, Pregnant

Core tip: We want to report our experience about the feasibility and safety of totally transthoracic echocardiography guided transcatheter device closure of atrial septal defect (ASD) in pregnant women. Device closure of ASD guided by fluoroscopy and echocardiography is mature with proven results and remains the preferred treatment option in most of hospitals. But for pregnant women with ASD, our procedure described in this study may be performed as another choice.