Abstract 301: Usefulness of 64-slice Cardiac Computed Tomography in the Assessment of Atrial Septal Defects in Patients Undergoing Percutaneous Occlusion
Introduction: During percutaneous closure of atrial septal defects (ASD) implantation failure may occur. In this study, we assess the usefulness of 64-slice computed tomography (CT) in patients with ASD submitted for cardiac catheterization and percutaneous closure of the defect.
Methods: From June-93 to June-09, 299 patients with ASD were treated percutaneously at our center. Since March-08, 30 consecutive patients 35±20 year old, with ASD were evaluated by echocardiogram and CT before catheterization; 11 of them were referred to surgery due to unsuitable anatomy. The remaining 19 underwent catheterization with transesophageal echocardiographic (TEE) monitoring for percutaneous closure of the defect. Multiplanar reformation of the CT images were done using the same views as in the TEE (retroaortic, 4-chamber and caves projections). In all 3 views we assessed the entire atrial septum obtaining 25–35 images at 1.5 mm intervals (75–105 septal views per patient). We selected the size of the device according to the maximum ASD diameter on any plane and the minimum dimension of the interatrial septum, as measured by CT. No Balloon sizing of the defect was performed. Additional angiography (pulmonary and coronary) was avoided with CT information.
Results: Amplatzer ASD occluders were used in all patients. Size was decided before catheterization. Primary success was obtained in all 19 patients. Correlations between TEE and CT measurements are summarized in table⇓.
Conclusion: Multiplane evaluation of the interatrial septum allows an accurate selection of occluder diameter and avoids the use of balloon sizing techniques and additional angiograms, simplifying the procedure.