Percutaneous left ventricular transapical access guided by cardiac 3D CT angiography combined with echocardiography
10.7507/1007-4848.201903060
- VernacularTitle:运用心脏CT血管造影三维重建结合超声心动图指导经皮经心尖左心室穿刺
- Author:
WANG Jie
1
;
RUAN Weiqiang
1
;
GAN Changping
1
;
DIAN Ke
1
Author Information
1. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
- Publication Type:Journal Article
- Keywords:
Cardiac 3D-CT angiography;
percutaneous transapical access;
structural heart defects
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(7):704-707
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the reliability and safety of the technique of percutaneous left ventricular transapical access guided by cardiac three dimensional CT angiography (3D-CTA) combined with echocardiography applied in structural heart defects. Methods The clinical data of 9 patients (7 males and 2 females with a median age of 50 years ranging from 43 to 64 years) with paravalvular leaks closed by percutaneous left ventricular transapical access in West China Hospital, from April 2015 to August 2018, were retrospectively analyzed. We applied preoperative cardiac 3D-CTA to define the puncture site and trace, which was established by combining with real-time guidance of transesophageal echocardiography (TEE/3D-TEE), and an occluder was deployed at the apical access point for hemostasis with real-time guidance of transthoracic echocardiography (TTE). Results The puncture needles were successfully introduced into the left ventricular cavity at one time in all patients without injury of lung tissue, coronary artery or papillary muscle. There was no occluder displacement or apex bleeding. One patient developed pleural effusion caused by intercostal artery injury. Conclusion That cardiac 3D-CTA is used to define puncture sites and trace with advantages of simplicity and repeatability. A safe access and secure exit of left ventricle can be achieved by combining with real-time guidance of echocardiography. There are acceptable technology-related complications.
