0247

COMPARISON OF INTRACARDIAC (ICE) AND TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY (TEE) IN GUIDING CATHETER CLOSURE OF ATRIAL SEPTAL DEFECT (ASD) AND PATENT FORAMEN OVALE (PFO)

Cao Q-L¹, Du Z-D^1,2, Wang Z¹, Koenig PR¹, Waight DJ¹, Hijazi ZM¹.

¹ University of Chicago, Chicago, Illinois, USA

² Capital Institute of Pediatrics, Beijing, China

Objectives: This study sought to compare ICE and TEE for guiding transcatheter closure of secundum ASD and PFO.

Methods: ICE was used to guide transcatheter closure of ASD (n=23) or PFO (n=7) by an Amplatzer device in 30 consecutive patients (F/M 19/17; age 6-80 years). ICE was performed using an Acuson machine with a 5.5-10 mHz (10F) ultrasound catheter probe. TEE was performed in the first 6 patients to compare with ICE results.

Results: ICE was performed successfully in all patients. The diameter of defects measured 3-27 mm (mean��SD 17��8mm, n=23) by ICE, and 3-27 mm (17��8mm, n=6) by TEE, with a close correlation (r=0.98, P<0.001). The balloon stretched diameter of ASDs measured by ICE ranged from 16-35 mm (25��6mm, n=23), by TEE from 16-36 mm (25��7mm, n=6), and by angiography 11-38 mm (24��8mm, n=23), with close correlation (r=0.96-0.97, P<0.01). Both TEE and ICE provided similar 4-chamber, long and short axis views of defects and devices, and provided color Doppler images for detection of atrial septal shunting. As ICE probe was within the right atrium, it provided higher resolution images. No general anesthetization was needed during the procedure in 23 patients under guidance of only ICE. All patients had successful device placement with complete closure rate of 93%.

Conclusions: ICE and TEE provides similar echocardiographic views and measurements for guiding transcatheter closure of ASD and PFO. ICE provides higher resolution images with no need of anesthetization, and is a potential guidance method for catheter closure of ASD and PFO.