The reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect

Abstract

Objective. To determine the reliability of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in predicting the size of an atrial septal defect (ASD). Material and methods. The study included 16 patients who underwent the catheter-based procedures to close an atrial septal defect between February 2008 and December 2011 at the Paediatrics Clinic, CCU Sarajevo, after clinical and TTE and TEE evaluation. In order to determine the assumed diameter of the balloon (A-SBD), we used the formula of quantification A-SBD=TTE defect diameter×1:09 + 3.9 mm and A-SBD=1.1× transesophageal diameter of ASD+2.0 mm. The ASD was examined using the long-axis view, the basal short-axis view, the apical four-chamber view and the subcostal view to observe its position, diameter and relation to neighbouring structures. The largest diameter was selected as the reference diameter. Results. Of the total number of treated patients, 11 were female. Treatment was conducted by a foreign and local team of invasive cardiologists. The average age of the patients was 8.43 years (2 -17 years). Apart from a transient disturbance of rhythm in the youngest patients, there were no other intra and postprocedural complications. The obtained formulas represent "our" default size of the SBD, based on measurements of TTE and TEE: A-SBD (TTE)=6.02+0.86×TTE and A-SBD (TEE)=3.93+0.86×TEE. Conclusion. ASD diameter determined by TTE and TEE can reliably determine the appropriate size needed Amplatzer Septal Occluder device.

Echocardiographic Evaluation of Changes in Cardiac Hemodynamics and Loading Conditions after Transthoracic Minimally Invasive Device Closure of Atrial Septal Defect

“…Some investigators have reported that transesophageal echocardiography and real-time three-dimensional ultrasound are more accurate than transthoracic echocardiography; [ 15 ] however, we believe that transthoracic echocardiography can be used for preoperative patient selection and intraoperative occluder placement with the assistance of an experienced ultrasonographer. [ 16 – 19 ] There have been many reports of follow-up of patients undergoing percutaneous ASD closure, most of these reports are concerned with residual shunting, occluder displacement, or thrombotic events. [ 20 , 21 ] Other investigators have reported results of echocardiography during postoperative follow-up of patients who have undergone percutaneous closure of ASD.…”

Safety and Effectiveness of Transthoracic Echocardiography and Transesophageal Echocardiography in the Interventional Closure of Atrial Septal Defects in Children: A Systematic Review and Meta-Analysis

“…After reading the full text, 67+98 articles that could not obtain the full text and had an incomplete experimental design were eliminated. Finally, six articles were obtained [12][13][14][15][16][17]. The literature screening process is shown in Fig.…”

“…The demographic and baseline characteristics of the patients are shown in Table 1 (Ref. [12][13][14][15][16][17]). In the included literature, patients were divided into different groups based on the various types of echocardiography of the studies.…”

“…Two studies [16,17] reported long-axis measurements. Among the included studies, heterogeneity was I 2 = 69%, and the meta-analysis results using the random effects model showed p = 0.07 (SMD = 1.41, 95% CI: -0.11 to 2.92, Fig.…”