Successful totally transthoracic echocardiography guided transcatheter device closure of atrial septal defect in pregnant women

BACKGROUND: Transcatheter device closure of atrial septal defect (ASD) guided by fluoroscopy and/or transesophageal echocardiography is a mature technology. Little study has focused on whether the technology can be guided totally by transthoracic echocardiography (TTE), even in pregnant women with ASD. AIM: To evaluate the safety and efficacy of totally TTE guided transcatheter device closure of ASD in pregnant women. METHODS: Six pregnant women (gestational age 20-26 wk) with ASD underwent transcatheter device closure totally guided by TTE at our cardiac center from January 2015 to August 2017. A routine transcatheter procedure without fluoroscopy or intubation and a domestic occluder were used in this study. RESULTS: All patients had successful closure with good clinical results, and the overall immediate complete closure rate was 100%. The size of the occluder deployed ranged from 20 to 32 mm (26.7 ± 4.3 mm), the procedure time ranged from 30 to 50 min (41.7 ± 7.5 min), and the length of hospital stay was 2-3 d (mean 2.2 ± 0.4 d). There were no serious cardiovascular related complications, and transient arrhythmias occurred in one patient during the procedure. During the follow-up period (3 mo to 2 years), no occluder dislodgement, residual fistulas, or thromboses occurred. All of the patients underwent vaginal delivery between 36 and 38 wk of gestation. CONCLUSION: Totally TTE guided transcatheter device closure of ASD in pregnant women may be safe and effective.