Introduction
ASD is one of the most common
congenital heart diseases, accounting
for about 10-20% of all congenital heart diseases(1).
Traditional treatments—surgical extracorporeal circulation operation
and transcatheter intervention therapy—have advantages and
disadvantages. Transcatheter interventional therapy causes minor trauma
and provides rapid recovery, but the use of radiation can damage the
function of bone marrow, genitals, thyroid and other organs, and the use
of contrast medium has a risk of an allergic reaction or renal
insufficiency (2,3). The surgical extracorporeal
circulation operation method is mature and has more indications, but it
needs extracorporeal circulation, causes major trauma and unsightly
incision. In recent years, echocardiography guided transcutaneous
closure of ASD has gradually been applied.
At present, the most common approach
for transcutaneous ASD occlusion under the guidance of echocardiography
is through femoral vein (4-9). However, this approach
requires a relatively long operation path and the patient requires a
long period of bedrest after femoral vein puncture. The femoral vein is
slender in young patients, which limits the application of this
technique. An alternative is to use the larger dimeter jugular vein,
increasing the suitability in younger children(10-12). This approach also has shorter operation path
and so requires shorter delivery system (11). Recent
reports have highlighted the safe and effective use of trans-jugular
ultrasound-guided closure of ASD (10-12). The use of
an adjustable curved sheath for transcutaneous occlusion by this
approach means the head of the sheath can be bent
0-900 , easing entry to left atrium through ASD under
the guidance of transesophageal echocardiography (TEE). Though
trans-jugular transcutaneous closure of ASD with an adjustable curved
sheath under echocardiography guidance is few reports. Since 2016, the
Heart Center of Henan Province People’s Hospital has started to use an
adjustable bent sheath to close ASD under echocardiography guidance. The
patients have been followed-up regularly, and the procedure has achieved
good results.
We report the safety and effectiveness of this method to provide more
information on this approach for clinicians interested in adopting the
method in suitable patients.