European Journal of Echocardiography Advance Access published online on September 24, 2007
European Journal of Echocardiography, doi:10.1016/j.euje.2007.07.001
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Assessing ASDs prior to device closure using 3D echocardiography. Just pretty pictures or a useful clinical tool?
Department of Paediatric Cardiology, Clark Clinic, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, BT2 6BE, Northern Ireland, UK
Received 28 March 2007; accepted after revision 22 July 2007.
* Corresponding author. Department of Paediatric Cardiology, Ward 32 Paul O'Gorman building, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK. Tel: +441173428196; fax: +441173428432. E-mail address: gareth.morgan{at}ubht.nhs.uk (G.J. Morgan).
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Abstract |
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Aims: To determine the usefulness of three-dimensional transthoracic echocardiography (3D echo) in assessment of secundum atrial septal defects (ASDs) considered for device closure. To compare the findings from 3D echo with those from two-dimensional transoesophageal echocardiography (TOE) regarding dimensions, morphology and suitability for device closure.
Methods and results: Twenty-four patients were enrolled in this prospective, crossover study. Three-dimensional echo and TOE data were collected, analysed and compared, assessing quantitative data including maximum defect diameter, area and circumference. Qualitative morphology such as the presence of fenestrations and the defect margins were noted, and an assessment of the suitability for device closure was made using each modality. Eighteen (75%) of the 3D data sets produced usable data for analysis. In each case the maximum diameter of the defect was larger on 3D echo than on TOE (mean difference = 0.34 cm, P < 0.001). On three occasions suitability for device closure could not be determined using 3D echo. On the other 15 occasions there was agreement between the TOE and 3D echo data.
Conclusions: Three-dimensional echo provides comparable data with TOE when attempting to predict suitability for device closure without the need for general anaesthetic or sedation. It also provides useful additional dynamic and morphological information.
Keywords: Interventional cardiology; Atrial septal defect; Catheterisation; Congenital heart disease; Atrial septum morphology; Three-dimensional echocardiography
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