Percutaneous atrial septal defect closure using transesophageal echocardiography without fluoroscopy in a pregnant woman: a case report

Authors

  • Radityo Prakoso Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia https://orcid.org/0000-0003-3345-6314
  • Rina Ariani Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Oktavia Lilyasari Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Yovi Kurniawati Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Sisca Natalia Siagian Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Indriwanto Sakidjan Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Poppy Soerwianti Roebiono Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Anna Ulfah Rahajoe Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Olfi Lelya Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Aditya Agita Sembiring Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia
  • Ganesja Moelia Harimurti Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center of Harapan Kita, Jakarta, Indonesia

DOI:

https://doi.org/10.13181/mji.cr.193161

Keywords:

atrial septal defect, catheterization, pregnant women, transesophageal echocardiography

Abstract

Transcatheter closure is the treatment of choice for atrial septal defect (ASD); it has good efficacy and minimal complications. However, this approach in a pregnant woman is limited due to the risk of radiation exposure. A novel fluoroscopy-free technique has been introduced to reduce x-ray exposure. This case reported the experience of an ASD transcatheter closure in a pregnant woman without fluoroscopy guidance. To the best of our knowledge, this is the first successful fluoroscopy-free technique for transcatheter closure in Indonesia. The case is a 26-year-old primigravida at 26 weeks gestational age with secundum ASD and pulmonary hypertension. Transcatheter closure was successfully performed with a Cera ASD occluder (Lifetech Scientific Corporation, China) no. 28 mm guided by transesophageal echocardiography. During the procedure, transient supraventricular tachycardia was developed. There were no other major or minor periprocedural complications. ASD transcatheter closure in a pregnant woman without fluoroscopy is feasible, safe, and effective.

Downloads

Download data is not yet available.

References

Schubert S, Kainz S, Peters B, Berger F, Ewert P. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol. 2012;101(9):691-700. https://doi.org/10.1007/s00392-012-0445-1

Ewert P, Berger F, Daehnert I, van Wees J, Gittermann M, Abdul-Khaliq H, et al. Transcatheter closure of atrial septal defects without fluoroscopy: feasibility of a new method. Circulation. 2000;101(8):847-9. https://doi.org/10.1161/01.CIR.101.8.847

Yang Y, Zhang W, Wu Q, Gao L, Jin W, Zhao T. Transcatheter closure of atrial septal defects without fluoroscopy: a well-established procedure for alternative use in children. EuroIntervention. 2016;12(5):e652-7. https://doi.org/10.4244/EIJV12I5A106

Cao H, Chen Q, Zhang GC, Chen LW, Qiu ZH, Lu H. Percutaneous device closure of atrial septal defect with totally transthoracic echocardiography guide, without x-ray machine. Medicine. 2016;95(44):e5256. https://doi.org/10.1097/MD.0000000000005256

Pan XB, Ou-Yang WB, Pang KJ, Zhang FW, Wang SZ, Liu Y, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol. 2015;28(4):390-5. https://doi.org/10.1111/joic.12214

Zanjani KS, Zeinaloo A, Malekan-Rad E, Kiani A, Bagheri MM. Transcatheter atrial septal defect closure under transthorasic echocardiography in children. Iran J Pediatr. 2011;21(4):473-8. http://dx.doi.org/10.5812/ijp.3906

Jia Y, Meng X, Li Y, Xu C, Zeng W, Jiao Y, et al. Percutaneous occluder device closure through femoral vein guidance by transthoracic echocardiography in adult atrial septal defect patients. J Thorac Dis. 2018;10(3):1460-7. https://doi.org/10.21037/jtd.2018.02.06

Yong G, Khairy P, De Guise P, Dore A, Marcotte F, Mercier LA, et al. Pulmonary arterial hypertension in patients with transcatheter closure of secundum atrial septal defects: a longitudinal study. Circ Cardiovasc Interv. 2009;2(5):455-62. https://doi.org/10.1161/CIRCINTERVENTIONS.108.826560

Acar P, Massabuau P, Elbaz M. Real-time 3D transoesophageal echocardiography for guiding Amplatzer septal occluder device deployment in an adult patient with atrial septal defect. Eur J Echocardiogr. 2008;9(6):822-3. https://doi.org/10.1093/ejechocard/jen178

D'Alto M, Mahadevan VS. Pulmonary arterial hypertension associated with congenital heart disease. Eur Respir Rev. 2012;21(126):328-37. https://doi.org/10.1183/09059180.00004712

Ewert P, Daehnert I, Berger F, Kaestner A, Krings G, Vogel M, et al. Transcatheter closure of atrial septal defects under echocardiographic guidance without x-ray: initial experiences. Cardiol Young. 1999;9(2):136-40. https://doi.org/10.1017/S1047951100008349

Published

2020-06-30

How to Cite

1.
Prakoso R, Ariani R, Lilyasari O, Kurniawati Y, Siagian SN, Sakidjan I, Roebiono PS, Rahajoe AU, Lelya O, Sembiring AA, Harimurti GM. Percutaneous atrial septal defect closure using transesophageal echocardiography without fluoroscopy in a pregnant woman: a case report. Med J Indones [Internet]. 2020Jun.30 [cited 2024Nov.25];29(2):228–32. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/3161

Issue

Section

Case Report/Series
Abstract viewed = 1092 times

Most read articles by the same author(s)