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Comparison of cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transesophageal echocardiography vs. contrast agent injection

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Chinese Medical Journal 2019年第3期132卷 285-293页

作者： Yuan-Jun Sun Xiao-Meng Yin Tao Cong Lian-Jun Gao Dong Chang Xian-Jie Xiao Qiao-Bing Sun Rong-Feng Zhang Xiao-Hong Yu Ying-Xue Dong Yan-Zong Yang Yun-Long Xia Department of Cardiology First Affiliated Hospital of Dalian Medical UniversityDalianUaoning 116011China

Background:Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.Methods:Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.Results:No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7±4.2 min vs. 17.9±5.9 min, P<0.05) and the amount of contrast agent (3.0±5.1 mL vs.18.1±3.4 mL, P<0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0±3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P=0.88).Conclusions:Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.

关键词： Atrial fibrillation Cryoballoon ablation Pulmonary veins Balloon occlusion transesophageal echocardiography

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Non-fluoroscopic percutaneous transcatheter closure of atrial septal defects in children under transesophageal echocardiographic guidance

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World Journal of Pediatrics 2018年第4期14卷 378-382页

作者： Wei-Ze Xu Xin-Yi Shou Jian-Hua Li Jian-Gen Yu Ze-Wei Zhang Jin Yu Jing-Jing Ye Heart Center Children's HospitalZhejiang University School of MedicineHangzhou 310052China Wenzhou Medical University Wenzhou 325035China

Background This study sought to investigate the feasibility, safety and effectiveness of transcatheter closure of atrial septal defects (ASDs) under the guidance of transesophageal echocardiography (TEE) in children. Methods We reviewed the medical records of patients who underwent percutaneous ASD closure at our center from August 2016 to December 2017. For a total of 88 patients who were identified as having a single-hole defect and were undergoing percutaneous transcatheter ASD closure, a procedure completely guided by TEE was performed. There were 31 male patients and 57 female patients. The patients' mean age was 60.09 ± 36.42 months (13–182 months), and their mean body weight was 20.16 ± 10.04 kg (9–77 kg). Patients were followed up by performing transthoracic echocardiography and obtaining chest X-rays and electrocardiograms. Results The transcatheter closure of ASDs was successful in all patients. The mean ASD size was 11.58 ± 5.31 mm (3–28 mm), and the mean size of the occlusion device was 16.07 ± 5.29 mm (6–36 mm). The mean procedural times were 13.33 ± 2.82 minutes (6–16 minutes). The mean hospitalization costs were 27,259.66 ± 2507.04 RMB (25,200.00–33,911.45 RMB). The mean postoperative hospital stay was 3.22 ± 0.53 days (3–5 days). Residual shunt, occlusion device shedding or displacement, and pericardial effusion were not observed during or after the operation. Conclusion Percutaneous transcatheter ASD closure completely guided by TEE is a feasible, safe, non-invasive and easy procedure.

关键词： Atrial septal defect Children Echocardiography Transcatheter closure transesophageal

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Natural orifice transesophageal thoracoscopic surgery:A review of the current state

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World Journal of Gastrointestinal Endoscopy 2010年第1期2卷 3-9页

作者： Brian G Turner Denise W Gee Gastrointestinal Unit Massachusetts General Hospital55 Fruit StreetBostonMA 02114United States Department of Surgery Massachusetts General Hospital15 Parkman StreetBostonMA 02114United States

Since the concept of Natural Orifice Translumenal Endoscopic Surgery(NOTES) was introduced,it has continued to gain significantly in popularity and enthusiasm for its potential clinical applications.The ability to perform conventional laparoscopic and thoracoscopic procedures without the creation of scars and perhaps faster and less painful recovery has prompted a worldwide devotion to further this field.While intraabdominal NOTES has rapidly transitioned from animal models to human trials,applying the NOTES concept to perform thoracic procedures has been slower to gain momentum.The goal of this review is to summarize the current state of transesophageal NOTES thoracoscopy by looking at its potential for diagnostic and therapeutic interventions as well as the challenges in transitioning to human trials.

关键词： Natural orifice translumenal endoscopic surgery transesophageal Thoracoscopy Mediastinoscopy Esophagotomy Natural orifice Endoscopy

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Diagnosis of intrathoracic mases by transesophageal color Doppler e graphy

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Chinese Medical Journal 1997年第9期 45-47页

作者：曾亮谭黎杰沈学东石美鑫

Objective To evaluate the value of transesophageal color Doppler echocardiography in the diagnosis of intrathoracic masses. Methods Twenty patients with intrathoracic masses were examined by transesophageal echocardiography (TEE), including 12 patients with central lung masses and 8 with mediastinal masses. The neoplasms were explored by two dimensional real time ultrasonography, Doppler color flow imaging (DCFI) and pulsed Doppler (PD). The results were compared with computed tomography (CT), operative and pathological examination findings. Results We were able to identify the size, structure (solid or cystic), anatomic relationship, metastatic lymph nodes and venous carcinoembolus of the masses. Furthermore, the hemodynamic data in the vasculature inside the masses were detected. Conclusions As a new method, TEE with Doppler technique is not only valuable in differentiating malignant and benign neoplasms but also useful for preoperative evaluation of the mass resectability in patients with intrathoracic neoplasms.

关键词：学东 mases intrathoracic color transesophageal e graphy Doppler Diagnosis

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transesophageal　ultrasonography　in　assessment　of　operability　for　advanced　esophageal　carcinoma

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Journal of Medical Colleges of PLA(China) 1994年第4期9卷 294-297页

作者：段云友贺声曹铁生张少玲黄裕新张广忖程庆书

ＴｒａｎｓｅｓｏｐｈａｇｅａｌｕｌｔｒａｓｏｎｏｇｒａｐｈｙｉｎａｓｓｅｓｓｍｅｎｔｏｆｏｐｅｒａｂｉｌｉｔｙｆｏｒａｄｖａｎｃｅｄｅｓｏｐｈａｇｅａｌｃａｒｃｉｎｏｍａＤｕａｎＹｕｎｙｏｕ（段云友）；ＨｅＳｈｅｎｇ... 详细信息

ＴｒａｎｓｅｓｏｐｈａｇｅａｌｕｌｔｒａｓｏｎｏｇｒａｐｈｙｉｎａｓｓｅｓｓｍｅｎｔｏｆｏｐｅｒａｂｉｌｉｔｙｆｏｒａｄｖａｎｃｅｄｅｓｏｐｈａｇｅａｌｃａｒｃｉｎｏｍａＤｕａｎＹｕｎｙｏｕ（段云友）；ＨｅＳｈｅｎｇ（贺声）；ＣａｏＴｉｅｓｈｅｎｇ（...

关键词： transesophageal ultrasonography esophageal neoplasms operable assessment

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transesophageal echocardiography as a quality control tool in thoracoscopic cardiac surgery:4-years’ experience

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South China Journal of Cardiology 2019年第2期20卷 69-78页

作者：雷迁曹忠明曾庆诗郭晓纲王晟谢斌黄焕雷郭惠明 Department of Anesthesiology Sichuan Academy of Medical Sciences and Sichuan Provincial People's HospitalUniversity of Electronic Science and TechnologyChengdu 610072 Department of Cardiac Surgery and Anesthesiology Guangdong Cardiovascular InstituteGuangdong General Hospital and Guangdong Academy of Medical SciencesGuangzhou 510080China

Background The utilization value of intraoperative transesophageal echocardiography in cardiac surgery is more and more important.However,the role of intraoperative transesophageal echocardiography on quality control during thoracoscopic cardiac surgery has not been comprehensively studied.Methods A retrospective study of transesophageal echocardiography application on patients underwent thoracoscopic cardiac surgery from 2012 to 2015 was conducted in a single cardiovascular center.General anesthesia and peripheral cardiopulmonary bypass were standardized for all patients.All procedures were performed through 3 holes made in the right chest wall.transesophageal echocardiography monitoring was routinely utilized in each patient.Results A total of 1387 patients underwent thoracoscopic cardiac surgery were involved in the study.The mean age of patients was 42.8±15.3 years with a female predominance(60.6%).The most common procedures were mitral valve replacement(n=507,36.6%),atrial septal defect repair(n=425,30.6%),and mitral valve plasty(n=294,21.2%).Other main procedures included correction of partial anomalous pulmonary venous connection,cor triatriatum,ventricular septal defect or partial atrioventricular canal,removal of left or right atrial myxoma,and tricuspid valve plasty or replacement.transesophageal echocardiography monitoring was useful at every stage of surgery without any major associated complications.Forty-four patients(3.2%)required surgical re-interventions immediately following transesophageal echocardiography evaluation.The reasons included unsatisfactory valve plasty,paravalvular leak,prosthetic dysfunction and residual shunting.The incidence of surgical re-intervention,as well as the mortality,decreased annually with increased surgical volume.Conclusions Intraoperative transesophageal echocardiography plays an important role in the quality control of thoracoscopic cardiac surgery.

关键词： transesophageal echocardiography minimally invasive cardiac surgery thoracoscopy quality control

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Assessment of left atrial appendage function by transesophageal echocardiography in patients two weeks after acute coronary syndromes

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Journal of Geriatric Cardiology 2005年第4期2卷 198-201页

作者： Grzegorz Piotrowski Zenon Gawor Dariusz Timler Jozef Tazbir District Specialistic Hospital by Miko aj Kopernik in ￡ód(z|') Poland

For many years in ischemic heart disease, ventricles rather than atria received attention so not much is known about left atrial function in left ventricular ischemia. Objective Our study aimed to evaluate left atrial appendage (LAA)function by means of biplane transesophageal echocardiography in patients ten days after acute coronary syndromes (ACS).Methods The study was performed on 16 adult patients (65.9±9.9 years old) in whom transesophageal echocardiography was done 10 days after ACS. The following left atrial appendage (LAA) planimetric parameters were analyzed: LAA transversal dimension, LAA longitudinal dimension,LAA maximal area, and LAA minimal area. LAA ejection fraction was calculated and analyzed. The following LAA Doppler parameters were analyzed: the peak LAA emptying and the peak LAA filling velocities.The control group consisted of 14 patients (43±14.6 years old) without cardiovascular diseases. Results Both LAA longitudinal dimension and LAA transversal dimension were significantly higher in patients with ACS than in control patients. The same was observed for LAA maximal area. Also LAA ejection fraction was higher in patients with ACS. LAA minimal area did not differ in the patients in either group. LAA peak emptying flow (LAAE) and LAA peak filling flow (LAAF) were significantly higher in patients of the study group than of the control group. Conclusion Our study shows that two weeks after acute coronary syndrome LAA as a reservoir as well as a pump works at a higher level than it does in the control group.

关键词： left atrial appendage acute coronary syndromes transesophageal echocardiography

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Diagnostic value of real-time three-dimensional transesophageal echocardiography for preoperative assessment of sinus venosus atrial septal defect

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South China Journal of Cardiology 2014年第2期15卷 125-129,170页

作者：郑智超费洪文陈欧迪朱伟许燕侯跃双 Department of Cardiology Guangdong Provincial Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences

Background Sinus venosus atrial septal defect（SVASD） is a rare atrial septal defect. The right-sided pulmonary veins may drain into the right atrium directly or via vena cava. Two-dimensional transthoracic echocardiography（2D-TTE） is certainly the initial choice of evaluation of SVASD but is unable to show its spatial relation to the surrounding structures and the configuration of the veins accurately. The purpose of this study was to evaluate the diagnostic accuracy of real-time three-dimensional transesophageal echocardiography（RT3D-TEE） for detecting SVASD and partial anomalous pulmonary venous connection（PAPVC）. Methods2D-TTE and RT3D-TEE were performed in 25 patients with the SVASD before surgical repair. Records of these patients were compared with surgical assessments. Results Twenty-three of the 25 patients with SVASD were detected by 2D-TTE. All the 23 patents were associated with PAPVC. Two of the 25 patients with SVASD were misdiagnosed as the secundum atrial septal defect by 2D-TTE. SVASD was demonstrated in all the 25 cases by RT3D-TEE, and 25 patents were associated with PAPVC. Conclusions RT3D-TEE is highly accurate, scientific method for displaying the location, size, shape of the defect and its spatial relation to the surrounding structures, and provides additional value to the surgeon and physicians for better understanding of spatial intracardiac morphology and making more accurate diagnosis and treatment.

关键词： echocardiography three-dimensional transesophageal sinus venosus atrial septal defect

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Noninvasive Assessment of Cardiac Index with transesophageal Echocardiography in Patients Undergoing Mitral Valve Replacement: A Comparison between Determinations at the Mitral Valve and the Ascending Aorta

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Open Journal of Anesthesiology 2013年第4期3卷 249-254页

作者： Xiaoju Hu Hongwei Shi Jinyan Yan Yali Ge Haiyan Wei Department of Anesthesiology Nanjing First Hospital Nanjing Medical University Nanjing China.

Methods: Sixteen patients with American Society of Anesthesiologists status (ASA) II-III, age ≤ 70 yr, male or female, preoperatively NYHA II-III and EF ≥ 45%, scheduled for mitral valve replacement (MVR) were studied. Complete intravenous general anesthesia was used for induction and anesthesia maintenance. After anesthesia induction we put the TEE probe into the esophagus. The cardiac index was determined at three periods following MVR: T1 30 minutes later following cessation of bypass, T2 60 minutes after cessation of bypass, T3 90 minutes after cessation of bypass. Statistical analysis was made with the Bland and Altman method. Results: Ninety-six measurements were compared. The cardiac index values at the level of prosthesis mitral valve (CIMV) ranged from 1.3 to 5.5 L·min-1·m-2 (mean 2.6 ± 0.9). The Values of cardiac index at aortic valve (CIAA) ranged from 2.7 to8.8 L·min-1·m-2 (mean 4.9 ± 1.7). Bias was -2.3 L·min-1·m-2 and limits of agreement -5.6 to 1.0 L·min-1·m-2. Conclusion: During mitral valve replacement, doubtful correlations were observed between values of cardiac index at the mitral valve and the ascending aorta using TEE.

关键词： Cardiac Index Cardiac Output transesophageal Echocardiography Mitral Valve Replacement Ascending Aorta

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Surgical Resection of Mitral Valve Papillary Fibroelastoma: A Robot-Assisted, Minimally Invasive Approach with Three-Dimensional transesophageal Echocardiography Imaging

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World Journal of Cardiovascular Surgery 2012年第2期2卷 10-13页

作者： Crystal R. Bonnichsen Harold M. Burkhart Kyle W. Klarich Rakesh M. Suri Division of Cardiovascular Diseases Mayo Clinic Rochester USA Division of Cardiovascular Surgery Mayo Clinic Rochester USA

Papillary fibroelastomas (PFEs) are benign tumors of the endocardium that most frequently affect cardiac valves and typically present with embolic symptoms such as stroke or transient ischemic attack (TIA). Surgical excision is usually recommended for left-sided tumors and is associated with excellent long-term outcomes. The use of a robot-assisted, minimally invasive surgical approach for management of mitral valve disease is growing, and has been associated with shorter hospital stays and improved early quality of life. Three-dimensional (3D) transesophageal echocardiography (TEE) offers several advantages in the assessment of mitral valve disease and cardiac tumors, including the ability to precisely locate the site of attachment of the mass and the spatial relationships to surrounding structures. These factors are particularly important when planning a surgical approach. We report two cases of mitral valve PFEs which were successfully removed using a robot-assisted, minimally invasive surgical approach with 3D TEE imaging. This approach to treatment of PFEs is an attractive alternative to the traditional approach involving median sternotomy.

关键词： Papillary Fibroelastoma Robotic Surgery Three-Dimensional transesophageal Echocardiography

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