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Abstract
Percutaneous closure is the treatment of choice for secundum-type atrial septal defects (ASD). Balloon sizing (BS) has been the method of choice for deciding on device size. Improved 2D- and 3D-transesophageal echocardiographic (TEE) imaging challenged the necessity of BS. Balloon sizing was performed with two additional techniques to measure the stretched dimension of the ASD. The 1st method uses a stiff guide wire which stretches the ASD and 2D TEE. The second technique uses 3D TEE. Two hundred and thirty-six patients with minimum 1-year follow-up were enrolled. The population was classified into three groups: BS (group 1) n = 90, 2D-TEE (group 2) n = 87, and 3D-TEE (group 3) n = 59. All groups showed a distinct correlation between the maximum baseline dimensions and the device size (R = 0.821). The relative expansion rate did not differ between BS and 3D-TEE. Group 2 (2D-TEE) showed a significantly lower expansion rate. Procedural success and complications did not differ statistically between the 3 groups. 2D TEE sizing was the simplest method without loss of accuracy. 3D sizing offers the advantage of accurate and fast shape assessment, but resulted in more undersizing. Accurate sizing of ASDs with a floppy septum remains a challenge.
Keywords
ASD, Percutaneous closure, Device, Sizing, Three dimensional, Echocardiography, ATRIAL SEPTAL-DEFECT, 3-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHY, TRANSCATHETER CLOSURE, OCCLUDER, SHAPE

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Please use this url to cite or link to this publication:

Chicago
Boon, Isabelle, Katrien Vertongen, Bernard P Paelinck, Laurent Demulier, An Van Berendoncks, Catherine De Maeyer, Fabienne Marchau, Joseph Panzer, Kristof Vandekerckhove, and Daniël De Wolf. 2018. “How to Size ASDs for Percutaneous Closure.” Pediatric Cardiology 39 (1): 168–175.
APA
Boon, I., Vertongen, K., Paelinck, B. P., Demulier, L., Van Berendoncks, A., De Maeyer, C., Marchau, F., et al. (2018). How to size ASDs for percutaneous closure. PEDIATRIC CARDIOLOGY, 39(1), 168–175.
Vancouver
1.
Boon I, Vertongen K, Paelinck BP, Demulier L, Van Berendoncks A, De Maeyer C, et al. How to size ASDs for percutaneous closure. PEDIATRIC CARDIOLOGY. 2018;39(1):168–75.
MLA
Boon, Isabelle, Katrien Vertongen, Bernard P Paelinck, et al. “How to Size ASDs for Percutaneous Closure.” PEDIATRIC CARDIOLOGY 39.1 (2018): 168–175. Print.
@article{8535784,
  abstract     = {Percutaneous closure is the treatment of choice for secundum-type atrial septal defects (ASD). Balloon sizing (BS) has been the method of choice for deciding on device size. Improved 2D- and 3D-transesophageal echocardiographic (TEE) imaging challenged the necessity of BS. Balloon sizing was performed with two additional techniques to measure the stretched dimension of the ASD. The 1st method uses a stiff guide wire which stretches the ASD and 2D TEE. The second technique uses 3D TEE. Two hundred and thirty-six patients with minimum 1-year follow-up were enrolled. The population was classified into three groups: BS (group 1) n = 90, 2D-TEE (group 2) n = 87, and 3D-TEE (group 3) n = 59. All groups showed a distinct correlation between the maximum baseline dimensions and the device size (R = 0.821). The relative expansion rate did not differ between BS and 3D-TEE. Group 2 (2D-TEE) showed a significantly lower expansion rate. Procedural success and complications did not differ statistically between the 3 groups. 2D TEE sizing was the simplest method without loss of accuracy. 3D sizing offers the advantage of accurate and fast shape assessment, but resulted in more undersizing. Accurate sizing of ASDs with a floppy septum remains a challenge.},
  author       = {Boon, Isabelle and Vertongen, Katrien and Paelinck, Bernard P and Demulier, Laurent and Van Berendoncks, An and De Maeyer, Catherine and Marchau, Fabienne and Panzer, Joseph and Vandekerckhove, Kristof and De Wolf, Dani{\"e}l},
  issn         = {0172-0643},
  journal      = {PEDIATRIC CARDIOLOGY},
  language     = {eng},
  number       = {1},
  pages        = {168--175},
  title        = {How to size ASDs for percutaneous closure},
  url          = {http://dx.doi.org/10.1007/s00246-017-1743-1},
  volume       = {39},
  year         = {2018},
}

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