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

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 u...

Full description

Saved in:
Bibliographic Details
Published in:Cardiovascular revascularization medicine Vol. 77; pp. 61 - 65
Main Authors: Shatla, Islam, Kennedy, Kevin, Saxon, John Thomas, Chhatriwalla, Adnan K., Magalski, Anthony, Lehenbauer, Kyle, Abdelkarim, Islam, Huber, Kenneth Christopher, Huded, Chetan P.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.08.2025
Subjects:
Aged
Atrial septal defect
Cardiac Catheterization - adverse effects
Cardiac Catheterization - economics
Cardiac Catheterization - instrumentation
Cardiovascular
Cost Savings
Cost-Benefit Analysis
Databases, Factual
Echocardiography, Transesophageal - adverse effects
Echocardiography, Transesophageal - economics
Female
Foramen Ovale, Patent - diagnostic imaging
Foramen Ovale, Patent - economics
Foramen Ovale, Patent - therapy
Heart Septal Defects, Atrial - diagnostic imaging
Heart Septal Defects, Atrial - economics
Heart Septal Defects, Atrial - therapy
Hospital Costs
Humans
Intracardiac echocardiography
Length of Stay
Male
Middle Aged
Patent foramen ovale
Patient Readmission
Predictive Value of Tests
Retrospective Studies
Risk Factors
Time Factors
Transesophageal echocardiography
Treatment Outcome
Ultrasonography, Interventional - adverse effects
Ultrasonography, Interventional - economics
United States
United States
Atrial septal defect
Patent foramen ovale
Transesophageal echocardiography
Intracardiac echocardiography
ISSN:1553-8389, 1878-0938, 1878-0938
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. •ICE-guided transcatheter PFO/ASD closures had a safety profile similar to TEE guidance within the context of measured adverse outcomes.•Both ICE and TEE had similarly low rates of in-hospital adverse events, but costs were less with ICE.•These results are reassuring and support the adoption of ICE as a primary imaging modality for transcatheter PFO/ASD closures.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1553-8389
1878-0938
1878-0938
DOI:10.1016/j.carrev.2024.09.016