Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion
| Autor: | Antonio Rodríguez Fernández, Armando Bethencourt González |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Percutaneous Septal Occluder Device medicine.medical_treatment Echocardiography Three-Dimensional Foramen secundum 030204 cardiovascular system & hematology Left atrial appendage occlusion Heart Septal Defects Atrial Atrial septal defects 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Fluoroscopy Atrial Appendage 030212 general & internal medicine Contraindication medicine.diagnostic_test business.industry Atrial fibrillation General Medicine medicine.disease Shunting Treatment Outcome Surgery Computer-Assisted Cardiology Radiology business Echocardiography Transesophageal |
| Zdroj: | Revista Española de Cardiología (English Edition). 69:766-777 |
| ISSN: | 1885-5857 |
| DOI: | 10.1016/j.rec.2016.04.024 |
| Popis: | Because of advances in cardiac structural interventional procedures, imaging techniques are playing an increasingly important role. Imaging studies show sufficient anatomic detail of the heart structure to achieve an excellent outcome in interventional procedures. Up to 98% of atrial septal defects at the ostium secundum can be closed successfully with a percutaneous procedure. Candidates for this type of procedure can be identified through a systematic assessment of atrial septum anatomy, locating and measuring the size and shape of all defects, their rims, and the degree and direction of shunting. Three dimensional echocardiography has significantly improved anatomic assessments and the end result itself. In the future, when combined with other imaging techniques such as cardiac computed tomography and fluoroscopy, 3-dimensional echocardiography will be particularly useful for procedure guidance. Percutaneous closure of the left atrial appendage offers an alternative for treating patients with atrial fibrillation and contraindication for oral anticoagulants. In the future, the clinical focus may well turn to stroke prevention in selected patients. Percutaneous closure is effective and safe; device implantation is successful in 94% to 99% of procedures. However, the procedure requires an experienced cardiac structural interventional team. At present, 3-dimensional echocardiography is the most appropriate imaging technique to assess anatomy suitability, select device type and size, guide the procedure alongside fluoroscopy, and to follow-up the patient afterwards. |
| Databáze: | OpenAIRE |
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