Imaging Techniques in Percutaneous Cardiac Structural Interventions: Atrial Septal Defect Closure and Left Atrial Appendage Occlusion.
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.
['Rodríguez Fernández|Antonio|A|', 'Bethencourt González|Armando|A|']
D020517:Atrial Appendage D006328:Cardiac Catheterization D019560:Echocardiography, Three-Dimensional D017548:Echocardiography, Transesophageal D005471:Fluoroscopy D006344:Heart Septal Defects, Atrial D006801:Humans D055989:Septal Occluder Device D025321:Surgery, Computer-Assisted D016896:Treatment Outcome
Atrial septal defect Left atrial appendage Atrial fibrillation 3D transesophageal echocardiography Comunicación interauricular Ecocardiograma transesofágico 3D Fibrilación auricular Orejuela izquierda