Safety and Effectiveness of Transthoracic Echocardiography and Transesophageal Echocardiography in the Interventional Closure of Atrial Septal Defects in Children: A Systematic Review and Meta-Analysis

Authors

  • Haiyan Lu Department of Ultrasound, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 318050 Taizhou, Zhejiang, China
  • Jindong Wang Quality Improvement Office, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 318050 Taizhou, Zhejiang, China
  • Lingjuan Zhou Department of Ultrasound, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 318050 Taizhou, Zhejiang, China
  • Lian Liu Department of Pediatrics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 318050 Taizhou, Zhejiang, China

DOI:

https://doi.org/10.59958/hsf.7353

Keywords:

atrial septal defect, meta-analysis, randomized controlled trial, transthoracic echocardiography, transesophageal echocardiography

Abstract

Objective: Through this meta-analysis, a systematic review was conducted on the effects of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in the interventional closure of atrial septal defects (ASDs) in children. Methods: We searched papers in the PubMed, Web of Science, Cochrane Library, Google Scholar, CNKI, Wanfang, Embase, and VIP databases. The search time limit was from the establishment of the database to May 2023. Randomized controlled trials on the effect of TTE and TEE in the interventional closure of ASD in children were screened. The included results were integrated and analyzed, and ReviewManager 5.4 was used for the meta-analysis. Results: Six studies with a total of 253 patients with ASD were included in this meta-analysis. Results showed that the surgical success rate in each study was more than 90%, with no difference between TEE and TTE (p = 0.11; risk ratio (RR) = 0.96, 95% confidence interval (CI): 0.89 to 1.04). The surgery time of TTE was significantly shorter than that of TEE (standard mean difference (SMD) = –1.52, 95% CI: –2.30 to –0.74). The fluoroscopy time of TTE was shorter than that of TEE (SMD = –0.69, 95% CI: –1.08 to –0.30). We found no significant difference in complication rates (RR = 0.36, 95% CI: 0.09 to 1.39). Conclusion: The combination of TTE and TEE is important during surgery, and postoperative complications are relatively small. The surgery time and fluoroscopy time of TTE are shorter than those of TEE.

References

Ma LG, Chen QH, Wang YY, Wang J, Ren ZP, Cao ZF, et al. Spatial pattern and variations in the prevalence of congenital heart disease in children aged 4-18 years in the Qinghai-Tibetan Plateau. The Science of the Total Environment. 2018; 627: 158–165.

Fraisse A, Latchman M, Sharma SR, Bayburt S, Amedro P, di Salvo G, et al. Atrial septal defect closure: indications and contra-indications. Journal of Thoracic Disease. 2018; 10: S2874–S2881.

Chowdhury UK, Anderson RH, Spicer DE, Sankhyan LK, George N, Pandey NN, et al. A review of the therapeutic management of multiple ventricular septal defects. Journal of Cardiac Surgery. 2022; 37: 1361–1376.

Wu SJ, Fan YF, Chien CY. Surgical or interventional treatment for adult patients with atrial septal defect and atrial fibrillation: A systemic review and meta-analysis. Asian Journal of Surgery. 2022; 45: 62–67.

Taqatqa AS, Vettukattil JJ. Atrioventricular Septal Defects: Pathology, Imaging, and Treatment Options. Current Cardiology Reports. 2021; 23: 93.

Peyvandi S, Donofrio MT. Circulatory Changes and Cerebral Blood Flow and Oxygenation During Transition in Newborns With Congenital Heart Disease. Seminars in Pediatric Neurology. 2018; 28: 38–47.

Rodríguez-Hernández JL, Rodríguez-González F, Riaño-Ruiz M, Martínez-Quintana E. Risk factors for hyperuricemia in congenital heart disease patients and its relation to cardiovascular death. Congenital Heart Disease. 2018; 13: 655–662.

Le Gloan L, Legendre A, Iserin L, Ladouceur M. Pathophysiology and natural history of atrial septal defect. Journal of Thoracic Disease. 2018; 10: S2854–S2863.

Oster M, Bhatt AB, Zaragoza-Macias E, Dendukuri N, Marelli A. Interventional Therapy Versus Medical Therapy for Secundum Atrial Septal Defect: A Systematic Review (Part 2) for the 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 139: e814–e830.

Vitarelli A, Mangieri E, Gaudio C, Tanzilli G, Miraldi F, Capotosto L. Right atrial function by speckle tracking echocardiography in atrial septal defect: Prediction of atrial fibrillation. Clinical Cardiology. 2018; 41: 1341–1347.

Jung SY, Choi JY. Transcatheter closure of atrial septal defect: principles and available devices. Journal of Thoracic Disease. 2018; 10: S2909–S2922.

Zhang YC, Xiao C, Zhong WQ, Liao HC. Children’s congenital room interval or room septal defects under the guidance of ultrasonic heart dynamic diagram The effect of blocking the esophagus or in the chest and the surgical ethical chest incision. Modern Chinese Drug Application. 2017; 11: 48–50. (In Chinese)

Azhar AS. Safety and efficacy of transthoracic versus transesophageal echocardiography in transcatheter closure of atrial septal defects. Reporting a single center experience from Saudi Arabia. Saudi Medical Journal. 2016; 37: 1196–1205.

Liu Y, Liu JC, Zhou XF. The comparison of the comparison of the breast and the meridian ultrasonic heartbeat in the catheter intervention and the mixture of the mixture. Western Medicine. 2013; 33: 165–169.

Bartakian S, El-Said HG, Printz B, Moore JW. Prospective randomized trial of transthoracic echocardiography versus transesophageal echocardiography for assessment and guidance of transcatheter closure of atrial septal defects in children using the Amplatzer septal occluder. JACC. Cardiovascular Interventions. 2013; 6: 974–980.

Mesihović-Dinarević S, Begić Z, Halimić M, Kadić A, Gojak R. The reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect. Acta Medica Academica. 2012; 41: 145–153.

Ko SF, Liang CD, Yip HK, Huang CC, Ng SH, Huang CF, et al. Amplatzer septal occluder closure of atrial septal defect: evaluation of transthoracic echocardiography, cardiac CT, and transesophageal echocardiography. AJR. American Journal of Roentgenology. 2009; 193: 1522–1529.

Eshraghi A, Aghaei-Moghadam E, Zeinaloo A, Rad EM, Zanjani KS, Ghalibafan, SF. Atrial Septal Defect Device Closure. Is Balloon Sizing Necessary? Iranian Journal of Pediatrics. 2021; 31: 108076.

Saric M, Perk G, Purgess JR, Kronzon I. Imaging atrial septal defects by real-time three-dimensional transesophageal echocardiography: step-by-step approach. Journal of the American Society of Echocardiography. 2010; 23: 1128–1135.

Xie LF, Lin Y, Chen MF, Zhang GC. Complete Transthoracic Echocardiography for the Assessment and Guidance of Percutaneous Atrial Septal Defect Closure in Adults without Balloon Sizing: An Observed Study with a 10-Year Follow-Up. Journal of Cardiovascular Development and Disease. 2023; 10: 321.

Yamano M, Yamano T, Nakamura T, Zen K, Shiraishi H, Shirayama T, et al. Appropriate selection of echocardiographic guidance for transcatheter atrial septal defect closure. The International Journal of Cardiovascular Imaging. 2020; 36: 855–863.

Al-Hamash S, Khalid KA, Khalaf OZ. Reliability of Transthoracic Echocardiography to Guide Transcatheter Closure of Atrial Septal Defects. Pathology and Laboratory Medicine. 2021; 5: 38.

Sharfi MH, Al-Ata J, Al-Kouatli A, Baho H, Al-Ghamdi L, Galal MO. Safety and efficacy of transcatheter closure of atrial septal defect type II under transthoracic echocardiographic guidance: A case control study. Journal of the Saudi Heart Association. 2019; 31: 2–8.

El Doklah EH, El Shedoudy SA, El Saied AM, Kassem HK, El Masry MM. Assessment of Value of Three Dimensional Transesophageal Echocardiography versus Conventional Two Dimensional Transesophageal Echocardiography in Guiding Transcatheter Closure of Atrial Septal Defects and Patent Foramen Ovale. Journal of the Saudi Heart Association. 2022; 34: 85–99.

Vervoort D, Meuris B, Meyns B, Verbrugghe P. Global cardiac surgery: Access to cardiac surgical care around the world. The Journal of Thoracic and Cardiovascular Surgery. 2020; 159: 987–996.e6.

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. Journal of the American College of Cardiology. 2002; 39: 1836–1844.

Jang JY, Heo R, Cho MS, Bae J, Hong JA, Lee S, et al. Efficacy of 3D transoesophageal echocardiography for transcatheter device closure of atrial septal defect without balloon sizing. European Heart Journal. Cardiovascular Imaging. 2018; 19: 684–689.

Qiu HF, Chen Q, Hong ZN, Chen LW, Huang XS. Transcatheter and intraoperative device closure and surgical repair for atrial septal defect. Journal of Cardiothoracic Surgery. 2019; 14: 136.

Acar P, Roux D, Dulac Y, Rougé P, Aggoun Y. Transthoracic three-dimensional echocardiography prior to closure of atrial septal defects in children. Cardiology in the Young. 2003; 13: 58–63.

Shah TR, Beig JR, Choh NA, Rather FA, Yaqoob I, Jan VM. Phase contrast cardiac magnetic resonance imaging versus transoesophageal echocardiography for the evaluation of feasibility for transcatheter closure of atrial septal defects. The Egyptian Heart Journal. 2022; 74: 27.

Seo Y, Ishizu T, Ieda M, Ohte N. Right ventricular three-dimensional echocardiography: the current status and future perspectives. Journal of Echocardiography. 2020; 18: 149–159.

Published

2024-06-19

How to Cite

Lu, H., Wang, J., Zhou, L., & Liu, L. (2024). Safety and Effectiveness of Transthoracic Echocardiography and Transesophageal Echocardiography in the Interventional Closure of Atrial Septal Defects in Children: A Systematic Review and Meta-Analysis. The Heart Surgery Forum, 27(6), E668-E679. https://doi.org/10.59958/hsf.7353

Issue

Section

Systematic Review