Original Scientific Articles
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Journal of Structural Heart Disease, June 2018, Volume 4, Issue 3:69-78
DOI: 10.12945/j.jshd.2018.039.17
Predictors of Procedure Time Prolongation During Percutaneous Transcatheter Closure of Atrial Septal Defect
A Retrospective Study
Milad El-Segaier, MD, PhD1*, Shehla Jadoon, MD1, Tariq Javid, MD1, Tariq A Wani, M. Sc. Statistics2, Mohammed Omar Galal, MD, PhD, MBA3
1 Department of Pediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia
2 Clinical and Translational Research Department, King Fahad Medical City, Riyadh, Saudi Arabia
Abstract
Background: Percutaneous transcatheter closure (PTCC) of atrial septal defect (ASD) may convert to a long procedure. We aimed to identify predictors of prolonged procedure.
Methods: Under transesophageal echocardiography and fluoroscopy guidance, 81 children with ASD underwent PTCC. Retrospectively, medical charts, echocardiographic recordings, catheterization reports and fluoroscopic films were reviewed. Demographics, echocardiographic measurements of ASD, dimensions of the device and hemodynamic data were collected. Prolonged procedure was defined as the duration from device deployment out of the delivery sheath to its release exceeding 10 minutes. A statistical model was designed using stepwise logistic regression analysis. Receiver operating characteristic curves were plotted to find the best cut-off for significant predictors.
Results: The procedure was prolonged in 25 patients. By monovariate analysis, the significant predictors for prolonged procedure were smaller, and younger patients, larger ASD, smaller left atrial (LA) dimensions and device waist ratios to weight, patient’s length, and LA dimensions. By multivariate analysis, the significant predictors were deficient septal rim toward superior vena cava (SVC) and device waist diameter in relation to patient’s length (best cut-off: < 12 mm and > 0.13, respectively). In three cases (3.7%) the device embolized; retrospectively possibly the cause is small used device and in one combined with vigorous physical activity.
Conclusions: A short septal rim toward superior vena cava and large device waist size in relation to patient size and/or LA dimensions may predict prolonged procedure during PTCC of ASD.
Cite this article as: El-Segaier M, Jadoon S, Javid T, Wani TA, Galal MO. Predictors of Procedure Time Prolongation During Percutaneous Transcatheter Closure of Atrial Septal Defect – A Retrospective Study. Structural Heart Disease 2018;4(3):69-78. DOI: 10.12945/j.jshd.2018.039.17
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Original Scientific Articles
Journal of Structural Heart Disease, June 2018, Volume 4, Issue 3:69-78
DOI: 10.12945/j.jshd.2018.039.17
Predictors of Procedure Time Prolongation During Percutaneous Transcatheter Closure of Atrial Septal Defect
A Retrospective Study
Milad El-Segaier, MD, PhD1*, Shehla Jadoon, MD1, Tariq Javid, MD1, Tariq A Wani, M. Sc. Statistics2, Mohammed Omar Galal, MD, PhD, MBA3
1 Department of Pediatric Cardiology, King Fahad Medical City, KSHC, Riyadh, Saudi Arabia
2 Clinical and Translational Research Department, King Fahad Medical City, Riyadh, Saudi Arabia
Abstract
Background: Percutaneous transcatheter closure (PTCC) of atrial septal defect (ASD) may convert to a long procedure. We aimed to identify predictors of prolonged procedure.
Methods: Under transesophageal echocardiography and fluoroscopy guidance, 81 children with ASD underwent PTCC. Retrospectively, medical charts, echocardiographic recordings, catheterization reports and fluoroscopic films were reviewed. Demographics, echocardiographic measurements of ASD, dimensions of the device and hemodynamic data were collected. Prolonged procedure was defined as the duration from device deployment out of the delivery sheath to its release exceeding 10 minutes. A statistical model was designed using stepwise logistic regression analysis. Receiver operating characteristic curves were plotted to find the best cut-off for significant predictors.
Results: The procedure was prolonged in 25 patients. By monovariate analysis, the significant predictors for prolonged procedure were smaller, and younger patients, larger ASD, smaller left atrial (LA) dimensions and device waist ratios to weight, patient’s length, and LA dimensions. By multivariate analysis, the significant predictors were deficient septal rim toward superior vena cava (SVC) and device waist diameter in relation to patient’s length (best cut-off: < 12 mm and > 0.13, respectively). In three cases (3.7%) the device embolized; retrospectively possibly the cause is small used device and in one combined with vigorous physical activity.
Conclusions: A short septal rim toward superior vena cava and large device waist size in relation to patient size and/or LA dimensions may predict prolonged procedure during PTCC of ASD.
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Cite this article as: El-Segaier M, Jadoon S, Javid T, Wani TA, Galal MO. Predictors of Procedure Time Prolongation During Percutaneous Transcatheter Closure of Atrial Septal Defect – A Retrospective Study. Structural Heart Disease 2018;4(3):69-78. DOI: 10.12945/j.jshd.2018.039.17
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