Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus

Background. Transcatheter closure of patent ductus arteriosus (TC-PDA), conventionally guided by aortography, has become the standard treatment of this disease. The purposes of this study were to evaluate whether intracardiac echocardiography (ICE) may be used for measuring PDA size and be used as a...

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Main Authors: Hironaga Yoshimoto, Maeda Yasuto, Tadashi Inoue, Yoshiyuki Kagiyama, Yozo Teramachi, Ryuta Takase, Yusuke Koteda, Yoshihiro Fukumoto, Motofumi Iemura, Kenji Suda
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2020/5147193
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author Hironaga Yoshimoto
Maeda Yasuto
Tadashi Inoue
Yoshiyuki Kagiyama
Yozo Teramachi
Ryuta Takase
Yusuke Koteda
Yoshihiro Fukumoto
Motofumi Iemura
Kenji Suda
author_facet Hironaga Yoshimoto
Maeda Yasuto
Tadashi Inoue
Yoshiyuki Kagiyama
Yozo Teramachi
Ryuta Takase
Yusuke Koteda
Yoshihiro Fukumoto
Motofumi Iemura
Kenji Suda
author_sort Hironaga Yoshimoto
collection DOAJ
description Background. Transcatheter closure of patent ductus arteriosus (TC-PDA), conventionally guided by aortography, has become the standard treatment of this disease. The purposes of this study were to evaluate whether intracardiac echocardiography (ICE) may be used for measuring PDA size and be used as a guide for TC-PDA. Methods. This study had 2 phases. In phase 1, we compared the measurements of PDA size: pulmonary artery side diameter (PA-D), length, and aortic side diameter (Ao-D) of PDA, as measured by ICE with those measured by aortography or cardiac computed tomography (AoG/CCT) in 23 patients who underwent TC-PDA. In phase 2, we compared the demographics, fluoroscopic time, contrast volume, and complications of the TC-PDAs between 10 adult patients with ICE guidance and 16 without it. Results. In phase 1, we found great correlation and agreement between ICE and AoG/CCT in PA-D (r = 0.985, bias −0.077 to 0.224), but moderate to poor correlation and agreement in length (r = 0.653, bias −0.491 to 3.065) and Ao-D (r = 0.704, bias 0.738 to 4.732), respectively. Nevertheless, all patients underwent successful TC-PDA with ICE guidance that allowed us to continuously monitor the whole process. In phase 2, TC-PDA required a significantly lower contrast volume with ICE guidance than without it, and there was no significant difference in the remaining variables between the 2 groups. Conclusion. ICE is comparable to AoG/CCT in providing accurate PA-D of the PDA and may be a safe alternative to guide TC-PDA as compared to conventional aortography.
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spelling doaj-art-7c6298ef36c34abeb31cd8a7b2cf0e882025-02-03T01:03:59ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/51471935147193Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus ArteriosusHironaga Yoshimoto0Maeda Yasuto1Tadashi Inoue2Yoshiyuki Kagiyama3Yozo Teramachi4Ryuta Takase5Yusuke Koteda6Yoshihiro Fukumoto7Motofumi Iemura8Kenji Suda9Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanDepartment of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, JapanDepartment of Pediatric Cardiology, St. Mary’s Hospital, Kurume, JapanDepartment of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, JapanBackground. Transcatheter closure of patent ductus arteriosus (TC-PDA), conventionally guided by aortography, has become the standard treatment of this disease. The purposes of this study were to evaluate whether intracardiac echocardiography (ICE) may be used for measuring PDA size and be used as a guide for TC-PDA. Methods. This study had 2 phases. In phase 1, we compared the measurements of PDA size: pulmonary artery side diameter (PA-D), length, and aortic side diameter (Ao-D) of PDA, as measured by ICE with those measured by aortography or cardiac computed tomography (AoG/CCT) in 23 patients who underwent TC-PDA. In phase 2, we compared the demographics, fluoroscopic time, contrast volume, and complications of the TC-PDAs between 10 adult patients with ICE guidance and 16 without it. Results. In phase 1, we found great correlation and agreement between ICE and AoG/CCT in PA-D (r = 0.985, bias −0.077 to 0.224), but moderate to poor correlation and agreement in length (r = 0.653, bias −0.491 to 3.065) and Ao-D (r = 0.704, bias 0.738 to 4.732), respectively. Nevertheless, all patients underwent successful TC-PDA with ICE guidance that allowed us to continuously monitor the whole process. In phase 2, TC-PDA required a significantly lower contrast volume with ICE guidance than without it, and there was no significant difference in the remaining variables between the 2 groups. Conclusion. ICE is comparable to AoG/CCT in providing accurate PA-D of the PDA and may be a safe alternative to guide TC-PDA as compared to conventional aortography.http://dx.doi.org/10.1155/2020/5147193
spellingShingle Hironaga Yoshimoto
Maeda Yasuto
Tadashi Inoue
Yoshiyuki Kagiyama
Yozo Teramachi
Ryuta Takase
Yusuke Koteda
Yoshihiro Fukumoto
Motofumi Iemura
Kenji Suda
Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
Journal of Interventional Cardiology
title Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
title_full Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
title_fullStr Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
title_full_unstemmed Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
title_short Intracardiac Echocardiography as a Guide for Transcatheter Closure of Patent Ductus Arteriosus
title_sort intracardiac echocardiography as a guide for transcatheter closure of patent ductus arteriosus
url http://dx.doi.org/10.1155/2020/5147193
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