Intracardiac vs. transesophageal echocardiography guided transcatheter closure of patent foramen ovale and atrial septal defects.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Revascularization Medicine Pub Date : 2024-09-24 DOI:10.1016/j.carrev.2024.09.016
Islam Shatla, Kevin Kennedy, John Thomas Saxon, Adnan K Chhatriwalla, Anthony Magalski, Kyle Lehenbauer, Islam Abdelkarim, Kenneth Christopher Huber, Chetan P Huded
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Abstract

Transcatheter closure of atrial septal defects (ASD) and patent foramen ovale (PFO) can be performed with transesophageal echocardiography (TEE) or intracardiac echocardiography (ICE) guidance, but data comparing both modalities in contemporary practice is lacking. Using ICD-10 codes, patients who underwent transcatheter ASD/PFO closure between 2016 and 2020 using ICE or TEE in the Nationwide Readmissions Database (NRD) were identified. Propensity-score matching was performed to compare in-hospital adverse events, length of stay (LOS), cost, and 30-day non-elective readmissions. A total of 964 patients underwent ASD/PFO closure with ICE (38.3 %, n = 369) or TEE (61.7 %, n = 595) between 2016 and 2020. Propensity score matching yielded 327 patients in each group, which were well balanced. Median (IQR) age was 59.0 (46.0, 72.0) years and 54.7 % were female. No difference was observed in the rate of in-hospital major adverse events between groups. ICE guidance was associated with a lower median cost (ICE $20,140.1 (14,622.3, 25,027.0) vs TEE $20,740.4 (14,137.5, 33,045.3), p < 0.04). In conclusion, ICE guided ASD/PFO closure was associated with lower hospitalization cost without increasing in-hospital adverse events when compared with TEE guidance.

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心内超声心动图与经食道超声心动图引导的经导管卵圆孔和房间隔缺损闭合术。
经导管关闭房间隔缺损(ASD)和卵圆孔未闭(PFO)可在经食道超声心动图(TEE)或心内超声心动图(ICE)的引导下进行,但目前还缺乏比较这两种模式在当代实践中的数据。利用ICD-10编码,在全国再入院数据库(NRD)中找到了2016年至2020年间使用ICE或TEE接受经导管ASD/PFO闭合术的患者。进行倾向分数匹配以比较院内不良事件、住院时间(LOS)、费用和 30 天非选择性再入院情况。2016年至2020年间,共有964名患者接受了ICE(38.3%,n = 369)或TEE(61.7%,n = 595)的ASD/PFO闭合术。倾向评分匹配结果显示,每组有 327 名患者,均衡性良好。中位(IQR)年龄为 59.0(46.0,72.0)岁,54.7% 为女性。两组患者的院内主要不良事件发生率无差异。ICE 指导的中位成本较低(ICE 20,140.1 美元 (14,622.3, 25,027.0) vs TEE 20,740.4 美元 (14,137.5, 33,045.3), p
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来源期刊
Cardiovascular Revascularization Medicine
Cardiovascular Revascularization Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.30
自引率
5.90%
发文量
687
审稿时长
36 days
期刊介绍: Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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