Skip to main content Accessibility help
×
Home
Hostname: page-component-7bb4899584-kqmjd Total loading time: 0.274 Render date: 2023-01-27T02:16:02.338Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder

Published online by Cambridge University Press:  22 December 2010

Shinich Itoh
Affiliation:
Department of Pediatric Cardiology, St. Mary's Hospital, Kurume City, Japan
Kenji Suda*
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Shintaro Kishimoto
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Hiroshi Nishino
Affiliation:
Department of Pediatric Cardiology, St. Mary's Hospital, Kurume City, Japan
Yoshiyuki Kudo
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Motofumi Iemura
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Yozo Teramachi
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Toyojiro Matsuishi
Affiliation:
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, Japan
Hiroshi Yasunaga
Affiliation:
Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Japan
*
Correspondence to: K. Suda, MD, Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume University, Kurume City, 67 Asahi-Machi, 830-0011, Japan. Tel: +81 942 31 7565; Fax: +81 942 38 1792; E-mail: suda_kenji@med.kurume-u.ac.jp

Abstract

Purpose

To determine the frequency and factors associated with increase in microembolic signals during transcatheter closure of atrial septal defect using the Amplatzer septal occluder.

Methods

During the procedure in 16 patients, we measured microembolic signals using transcranial Doppler. Procedure time was divided into five periods: right cardiac catheterisation; left cardiac catheterisation; left cardiac angiocardiography; sizing and long sheath placement; device placement and release. We compared numbers of microembolic signals among the five periods and identified factors associated with them.

Results

Mean size of septal occluder was 16 millimetres in diameter. Total number of microembolic signals was a median of 31.5, ranging from 3 to 113. Microembolic signals in three periods, left cardiac catheterisation; sizing, and long sheath placement; and device placement and release, were not significantly different from one another, but were significantly higher than those in the remaining two periods, right cardiac catheterisation and left cardiac angiocardiography (median was 9 in left cardiac catheterisation; 6 in sizing and long sheath placement; 6.5 in device placement and release, versus 0 in right cardiac catheterisation and 1 in left cardiac angiocardiography, p less than 0.05, respectively). Importantly, the time for device manipulation positively correlated with total number of microembolic signals (r equals 0.77, p less than 0.001), although fluoroscopic time, age, or size of septal occluder did not.

Conclusions

Transcatheter closure of atrial septal defect using the Amplatzer septal occluder produces microemboli, especially during device placement. To minimise the risk of systemic embolism, we must decrease the time for device manipulation.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Du, ZD, Hijazi, ZM, Kleinman, CS, Silverman, NH, Larntz, K, Amplatzer investigators. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol 2002; 39: 18361844.CrossRefGoogle Scholar
2. Ferrari, J, Baumgartner, H, Tentschert, S, et al. Cerebral microembolism during transcatheter closure of patent foramen ovale. J Neurol 2004; 251: 825829.CrossRefGoogle ScholarPubMed
3. Morandi, E, Anzola, GP, Cailli, F, Onorato, E. Silent brain embolism during transcatheter closure of patent foramen ovale: a transcranial Doppler study. Neurol Sci 2006; 27: 328331.CrossRefGoogle ScholarPubMed
4. Leclercq, F, Kassnasrallah, S, Cesari, JB, et al. Transcranial Doppler detection of cerebral microemboli during left heart catheterization. Cerebrovasc Dis 2001; 12: 5965.CrossRefGoogle ScholarPubMed
5. Bladin, CF, Bingham, L, Grigg, L, Yapanis, AG, Gerraty, R, Davis, SM. Transcranial Doppler detection of microemboli during percutaneous transluminal coronary angioplasty. Stroke 1998; 29: 23672370.CrossRefGoogle ScholarPubMed
6. Amin, Z, Hijazi, ZM, Bass, JL, Cheatham, JP, Hellenbrand, WE, Kleinman, CS. Erosion of Amplatzer septal occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv 2004; 63: 496502.CrossRefGoogle ScholarPubMed
7. Wahab, HA, Bairam, AR, Cao, QL, Hijazi, ZM. Novel technique to prevent prolapse of the Amplatzer septal occluder through large atrial septal defect. Catheter Cardiovasc Interv 2003; 60: 543545.CrossRefGoogle Scholar
8. Varma, C, Benson, LN, Silversides, C, et al. Outcomes and alternative techniques for device closure of the large secundum atrial septal defect. Catheter Cardiovasc Interv 2004; 61: 131139.CrossRefGoogle Scholar
9. Kannan, BR, Francis, E, Sivakumar, K, Anil, SR, Kumar, RK. Transcatheter closure of very large (> or =25 millimetre) atrial septal defects using the Amplatzer septal occluder. Catheter Cardiovasc Interv 2003; 59: 522527.CrossRefGoogle Scholar
10. Dalvi, BV, Pinto, RJ, Gupta, A. New technique for device closure of large atrial septal defects. Catheter Cardiovasc Interv 2005; 64: 102107.CrossRefGoogle Scholar
11. Kloska, SP, Wintermark, M, Engelhorn, T, Fiebach, JB. Acute stroke magnetic resonance imaging: current status and future perspective. Neuroradiology 2010; 52: 189201.CrossRefGoogle Scholar
8
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Microembolic signals measured by transcranial Doppler during transcatheter closure of atrial septal defect using the Amplatzer septal occluder
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *