Transesophageal Echocardiography Guided Patent Ductus Arteriosus Occlusion with a Duct Occluder. (1st October 2013)

• Record Type: Journal Article
• Authors: Silva, J.; Domenech, O.; Mavropoulou, A.; Oliveira, P.; Locatelli, C.; Bussadori, C.
• Is Part Of: Journal of veterinary internal medicine. Volume 27:Number 6(2013:Nov./Dec.)
• Page Start: 1463
• Page End: 1470
• Publication Date: 2013-10-01
• Subjects: Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.12201
• Languages: English
• ISSNs: 0891-6640

Abstract

<abstract abstract-type="main" id="jvim12201-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jvim12201-sec-0001" sec-type="section"> <title>Background</title> <p>Angiography and fluoroscopy are the standard methods to guide transcatheter occlusion of patent ductus arteriosus (PDA). The use of iodinated contrast agents and radiation exposure pose risks of animals and staff.</p> </sec> <sec id="jvim12201-sec-0002" sec-type="section"> <title>Objectives</title> <p>To assess feasibility of transesophageal echocardiography (TEE) for device size selection and procedure monitoring for PDA occlusion with a duct occluder (DO) without the use of angiography.</p> </sec> <sec id="jvim12201-sec-0003" sec-type="section"> <title>Animals</title> <p>Eighty client‐owned dogs with left‐to‐right PDA.</p> </sec> <sec id="jvim12201-sec-0004" sec-type="section"> <title>Methods</title> <p>Prospective study. Dogs with left‐to‐right PDA undergoing transcatheter occlusion were included. Procedures were performed without angiography and device size selection was based on TEE measurements. Procedures were monitored with simultaneous TEE and fluoroscopy and both methods were compared. Visualization of the ductus and dimensions obtained by TEE and transthoracic echocardiography (TTE) were compared.</p> </sec> <sec id="jvim12201-sec-0005" sec-type="section"> <title>Results</title> <p>Complete PDA occlusion was achieved in 79/80 cases. TEE was consistently superior to TTE for PDA visualization and the latter showed higher values for ductal dimensions when compared to the former. TEE provided adequate procedure monitoring in 73 cases (91%). Fluoroscopy exposure time (2.77 ± 1.2 minutes (mean, SD)) was lower than previously reported for the same procedure.</p> </sec> <sec id="jvim12201-sec-0006" sec-type="section"> <title>Conclusions and Clinical Importance</title> <p>TEE is a useful and efficient tool for device size selection and can be used for procedure monitoring in most cases. Fluoroscopy exposure time can be reduced and the use of contrast agents can be avoided. However, fluoroscopy is required in a minority of cases when TEE monitoring is not feasible or incomplete and should be available for this procedure.</p> </sec> </abstract>