ABSTRACT
Background: Transcatheter device closure of ostium secundum atrial septal defect is a safe & effective intervention in older children, & is usually done under transesophageal echocardiography guidance. However, the procedure under transthoracic echocardiography guidance, especially in smaller children, is done only at few centers, the data of which is scarce. Methods: A prospective study was undertaken to assess the mid-term efficacy and outcome of transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiographic guidance, in children <15 Kg. Results: Eighty three children with ostium secundum atrial septal defect were included in the study. Median age of the study population was 3.5 years (1.9-5.6 years), and median weight of 11.6 Kg (7.6 - 14.9 Kg). The primary and secondary procedural success rates were 94% and 96.4% respectively. Post procedure patients were followed up for 12-30 months. Device related major complications were encountered in 4 (4.8%) cases. The total occlusion rates of the defect at 24 hours, 1 month and 3 months post procedure were 94%, 98.8% and 100% respectively. Conclusion: The transcatheter device closure of ostium secundum atrial septal defect under transthoracic echocardiography guidance, in children <15 Kg, has a high short and mid-term safety and efficacy.
ABSTRACT
Objectives: To observe the phenomenon of transient expansion of right heart during contrast-enhanced ultrasound (CEUS) by SonoVue?ultrasound contrast agent (UCA) in Chinese experimental mini-pig , and to explore the possible causes of this phenomenon. Methods: 24 healthy Chinese experimental mini-pigs were randomly divided into 3 groups according to the dose of injected contrast agent: 2 ml group (n=8), 1 ml group (n=8) and 0.5 ml group (n=8). Cardiac structure and function at baseline and during contrast procedure were determined by contrast-enhanced echocardiography. Pigs in each group received bolus contrast agent injection followed by 5ml saline flush with baseline concentration, 2, 4 and 6-fold serial dilutions, respectively. When the right heart enlargement appeared, stop the injection and next injection followed after the right heart returned its original size. The study protocols discontinued at the time when the right heart enlargement did not appear post injection. Results: In 2 ml group, the number of right heart enlargement with different injection concentrations was 7, 6, 4, 3, respectively; in 1 ml group, the number of right heart enlargement with different injection concentrations was 6, 5, 3, 1; in 0.5 ml group, the number of right heart enlargement with different injection concentrations was 5, 5, 2, and 0, respectively. Incidence of right heart enlargement decreased in proportion with lower contrast agent amount, and lower contrast concentration(P<0.001). The right heart enlargement phenomenon occurred at about (26±15) s after the injection and lasted for about (47±21) s. Conclusions:Transient expansion of right heart phenomenon is common by bolus injection of contrast agent during CEUS in the Chinese mini-pigs, which may be related to the injected concentration and dosage of the contrast agent, as well as the injection mode and animal species.
ABSTRACT
A markedly enlarged right heat with a normal outflow tract was detected by fetal echocardiography in a fetus at 28 week's gestation. Follow-up scan at 32 week's gestation also showed asymmetric ventricles. The neonate were normal after delivery. Marked discrepancy between the sizes of the right and left ventricle generally indicates structural heart anomaly, such as coactation of aorta, hypoplastic left heat syndrome, or right ventricular outflow tract obstruction. But we experienced a case of marked fetal ventricular size discrepancy on 4 chamber view and turned out to be normal heart postnatally.