Bedside transesophageal echocardiography-guided atrial septostomy under extracorporeal membrane oxygenation support
10.3969/j.issn.1004-8812.2025.04.002
- VernacularTitle:体外膜肺氧合下床旁经食管超声心动图引导房间隔造口术
- Author:
Ang LIU
1
;
Ke WANG
;
Fu-jian DUAN
;
Wen-ying KANG
;
Jun-song GONG
;
PINGCUO-YUNDAN
;
Chao-wu YAN
Author Information
1. 国家心血管病中心 北京协和医学院 中国医学科学院阜外医院结构性心脏病中心,北京 100037
- Publication Type:Journal Article
- Keywords:
Transesophageal echocardiography;
Extracorporeal membrane oxygenation;
Atrial septostomy;
Left atrial decompression
- From:
Chinese Journal of Interventional Cardiology
2025;33(4):189-194
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure＜15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P＜0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.
