Impact of dynamic 3D transoesoesophageal echoardiography in the assessment of atrial septal defects and occlusion by the double-umbrealla device(CardioSEAL)

1998 ◽  
Vol 8 (3) ◽  
pp. 368-378 ◽  
Author(s):  
Yasuki V. Maeno ◽  
Lee N. Benson ◽  
Christine Boutin
Keyword(s):  
Three Dimensional ◽  
Transoesophageal Echocardiography ◽  
Relevant Information ◽  
3D Echocardiography ◽  
Cross Sectional ◽  
Transcatheter Occlusion ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Interventional Catheterization ◽  
Three Dimensional Echocardiography

AbstractOcclusion of the atrial septal defects in the oval fossa by interventional catheterization has progressed, but still has limitations. Three-dimensional (3D) echocardiography can provide unique views unavailable by cross-sectional imaging. The objective of this study was to define the clinical application of 3D echocardiography in the assessment and monitoring of transcatheter occlusion of atrial septal defects. Three-dimensional echocardiography was attempted prior to occlusion of atrial septal defects in 41 patients (median age 8.6 years). Serial cross-sectional images were acquired by multiplane transoesophageal echocardiography and displayed by means of computer reconstruction. Dynamic 3D echocardiographic images of defects in the oval fossa were obtained in 40 of 41 patients (98%). Volume-rendering demonstrated the anterosuperior rim in 36 (90%) and the inferoposterior rim in 24 (60%), but failed to reveal small additional fenestrations in six. Sizes measured by 3D echocardiography were significantly larger than those provided by cross-sectional transoesophageal echocardiography (p =;0.007), but differed little from those obtained with balloon sizing (p =; 0.6). After occlusion, 3D echocardiography showed positions of all arms of the device in 20 of 24 cases. Location of any protruding arms, or residual defects, were also clearly revealed.Three-dimensional images obtained in 12 patients during deployment of the double-umbrella device were useful in monitoring its position (single-frame) and for explaining the mechanism of protrusion. Current 3D echocardiography provides clinically relevant information for selection of patients for closure of atrial septal defects by interventional catheterization and when monitoring during implantation. Information obtained by this technique can clarify the mechanism of deployment of the device and closure of the defect, therefore influencing outcomes.

scholarly journals The role of three-dimensional transesophageal echocardiography in preoperative assessment of atrial septal defects

2015 ◽  
Vol 18 (1) ◽  
pp. 58 ◽  
Author(s):  
D. G. Tarasov ◽  
I. V. Tkachev ◽  
S. S. Kadrabulatova
Keyword(s):  
Atrial Septal Defect ◽  
Transesophageal Echocardiography ◽  
Septal Defect ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Maximum Diameter ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

An atrial septal defect is the most common congenital heart disease. Transcatheter defect closure has become widespread in recent times and the requirements for this procedure are rather strict. Two-dimensional echocardiography is limited in evaluating atrial septal defects because it provides planar images only. In order to preoperatively assess atrial septal defects, we applied three-dimensional transesophageal echocardiography and then compared the results with those of surgical operations. The maximum diameter, shape, area and localization of the atrial septal defect in 26 patients were estimated with three-dimensional echocardiography. It was found out that positive correlation existed between three-dimensional echocardiography findings and those measured during surgery. Three-dimensional echocardiography provides invaluable assistance in preoperative evaluation of atrial septal defects and in selection of treatment.

Echocardiographic considerations during deployment of the Helex Septal Occluder for closure of atrial septal defects

2003 ◽  
Vol 13 (3) ◽  
pp. 290-298 ◽  
Author(s):  
Leo Lopez ◽  
Roque Ventura ◽  
Elizabeth M. Welch ◽  
David G. Nykanen ◽  
Evan M. Zahn
Keyword(s):  
Three Dimensional ◽  
Intracardiac Echocardiography ◽  
New Device ◽  
Septal Defects ◽  
Acoustic Interference ◽  
Atrial Septal Defects ◽  
Helex Septal Occluder ◽  
Interventional Catheterization

The Helex Septal Occluder is a new device used to close atrial septal defects via interventional catheterization. In order to study the role of echocardiography during its use, and to describe the morphologic variants of defects suitable for closure with this occluder, we evaluated all patients undergoing intended closure of an atrial septal defect with the Helex occluder. A combination of transthoracic, transesophageal, three-dimensional, and intracardiac echocardiography were used before, during, and after the procedure to characterize anatomy, assess candidacy for closure, guide the device during its deployment, and evaluate results. Among the 60 candidates included in the study, 11 were excluded because of transesophageal echocardiographic and/or catheterization data obtained in the laboratory. Attempts at closure were successful in 46 patients, and unsuccessful in 3. We successfully treated four types of defects. These were defects positioned centrally within the oval fossa with appreciable rims along the entire circumference of the defect, defects with deficient or absent segments of the rim, defects with aneurysm of the primary atrial septum, and defects with multiple fenestrations. Follow-up transthoracic echocardiograms taken at a median of 7 months demonstrated no residual defects in 21, trivial residual defects in 17, and small residual defects in 8 patients. In 20 patients, three-dimensional reconstructions were used to characterize the morphology of the defect and the position of the device. Because transesophageal echocardiography was often limited by acoustic interference from the device, intracardiac echocardiography was utilized in 3 cases to overcome this limitation.

Transthoracic three-dimensional echocardiography prior to closure of atrial septal defects in children

2003 ◽  
Vol 13 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Philippe Acar ◽  
Daniel Roux ◽  
Yves Dulac ◽  
Pierre Rougé ◽  
Yacine Aggoun
Keyword(s):  
Three Dimensional ◽  
Mean Difference ◽  
Complete Agreement ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Maximal Diameter ◽  
The Mean ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Aims:Our aims were to use transthoracic three-dimensional echocardiography to assess the morphology of atrial septal defects in children prior to closure, and to compare the three-dimensional echocardiographic data with transcatheter and surgical findings.Methods and results:We used transthoracic three-dimensional echocardiography in 62 consecutive patients, aged from 2 to 18 years, with atrial septal defects, measuring the maximal diameter and the extent of the rims. Subsequent to the study, we referred 42 patients for transcatheter closure, the rims being measured at greater than 4 mm. We found a good correlation between the maximal diameter of the defect as measured at transthoracic three-dimensional echocardiography and using a balloon (y = 3.45 − 0.73x; r = 0.78; p < 0.0001), the mean difference between the measurements being 2.4 ± 2.8 mm. Successful closure with the Amplatzer septal occluder, having a mean size of 22 ± 4 mm, was achieved in 95% of the patients. Of the original cohort, 20 patients were referred for surgical closure. In these patients, the inferior rim had been deemed insufficient in 5, the postero-superior rim in 6, and the postero-inferior rim in 9. Complete agreement was found when the deficiency of the rim as judged using transthoracic three-dimensional echocardiography was compared with intraoperative findings. The correlation between measurements of the deficiency of the rim achieved by transthoracic three-dimensional echocardiography and at surgery was excellent (y = 0.2 + 0.98x; r = 0.93; p < 0.0001), the mean difference between the measurements being no more than 0.6 ± 0.4 mm.Conclusions:Transthoracic three-dimensional echocardiography proved accurate in measuring the maximal diameter and rims of atrial septal defects within the oval fossa. This non-invasive method will be valuable in selecting children for transcatheter or surgical closure of such defects.

Monitoring Complex Secundum Atrial Septal Defects Percutaneous Closure with Real Time Three-Dimensional Echocardiography

2012 ◽  
Vol 29 (6) ◽  
pp. 729-734 ◽  
Author(s):  
Daniel García-Fuertes ◽  
Dolores Mesa-Rubio ◽  
Martín Ruiz-Ortiz ◽  
Mónica Delgado-Ortega ◽  
Ignacio Tejero-Mateo ◽  
...  
Keyword(s):  
Real Time ◽  
Three Dimensional ◽  
Percutaneous Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography

Three-Dimensional Echocardiography Guided Closure of Complex Multiple Atrial Septal Defects

2014 ◽  
Vol 31 (10) ◽  
pp. E304-E306 ◽  
Author(s):  
Yasufumi Kijima ◽  
Teiji Akagi ◽  
Koji Nakagawa ◽  
Yoichi Takaya ◽  
Hiroki Oe ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography
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