Kyoko Kaku1, Masaaki Takeuchi2, Lissa Sugeng3, Joseph A Lodato3, Hiromi Nakai1, Lynn Weinert3, Kyoko Otani1, Hidetoshi Yoshitani1, Nobuhiko Haruki1, Ziyad M Hijazi4, Yutaka Otsuji1, Roberto M Lang3. 1. Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. 2. Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. takeuchi@med.uoeh-u.ac.jp. 3. Non-invasive Imaging Laboratory, University of Chicago Medical Center, Chicago, IL, USA. 4. Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, IL, USA.
Abstract
BACKGROUND: Accurate preoperative determination of defect location and size is important for successful transcatheter closure of atrial septal defects (ASD). Real-time 3D transesophageal echocardiography (3DTEE) has the potential to delineate the shape of ASD in 3D space. METHODS: Full volume and 3D zoom datasets by 3DTEE were acquired in 17 ASD patients. Using quantitative software, maximal/minimal diameter, defect area and residual rim length were measured and compared to the standard 2D measurements. RESULTS: Real-time 3DTEE allowed delineation of the en-face view of the ASDs. The defect typically had an oval shape, and its size changed dynamically, having its minimal size at end-diastole and maximal at end-systole. A good correlation was noted between the maximal defect area by 3DTEE and 2DTEE (r = 0.93, p < 0.001). Successful delineation of rim length to the specific cardiac structure was 100% by 3DTEE and 88% by 2DTEE. There was a fair correlation of residual rim length between 3DTEE and 2DTEE (r = 0.69, p < 0.001). Eight patients underwent transcatheter closure of the ASD. Excellent correlation was noted between 3D-derived maximal defect diameter and device diameter (r = 0.97, p < 0.001). CONCLUSIONS: Real-time 3DTEE allows measurements of the temporal and spatial changes of ASD size and shape. This methodology provides detailed information on defect dynamics.
BACKGROUND: Accurate preoperative determination of defect location and size is important for successful transcatheter closure of atrial septal defects (ASD). Real-time 3D transesophageal echocardiography (3DTEE) has the potential to delineate the shape of ASD in 3D space. METHODS: Full volume and 3D zoom datasets by 3DTEE were acquired in 17 ASDpatients. Using quantitative software, maximal/minimal diameter, defect area and residual rim length were measured and compared to the standard 2D measurements. RESULTS: Real-time 3DTEE allowed delineation of the en-face view of the ASDs. The defect typically had an oval shape, and its size changed dynamically, having its minimal size at end-diastole and maximal at end-systole. A good correlation was noted between the maximal defect area by 3DTEE and 2DTEE (r = 0.93, p < 0.001). Successful delineation of rim length to the specific cardiac structure was 100% by 3DTEE and 88% by 2DTEE. There was a fair correlation of residual rim length between 3DTEE and 2DTEE (r = 0.69, p < 0.001). Eight patients underwent transcatheter closure of the ASD. Excellent correlation was noted between 3D-derived maximal defect diameter and device diameter (r = 0.97, p < 0.001). CONCLUSIONS: Real-time 3DTEE allows measurements of the temporal and spatial changes of ASD size and shape. This methodology provides detailed information on defect dynamics.
Entities:
Keywords:
3D transesophageal echocardiography; ASD; Device closure
Authors: Lissa Sugeng; Stanton K Shernan; Ivan S Salgo; Lynn Weinert; Doug Shook; Jai Raman; Valluvan Jeevanandam; Frank Dupont; Scott Settlemier; Bernard Savord; John Fox; Victor Mor-Avi; Roberto M Lang Journal: J Am Coll Cardiol Date: 2008-08-05 Impact factor: 24.094
Authors: Roberto Martin-Reyes; Teresa López-Fernández; Mar Moreno-Yangüela; Raul Moreno; Miguel Angel Navas-Lobato; Elena Refoyo; Gabriela Guzmán; Francisco Domínguez-Melcón; Jose Luis López-Sendón Journal: Eur J Echocardiogr Date: 2008-08-26