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

Author(s): Senka Mesihović-Dinarević | Zijo Begić | Mirza Halimić | Almira Kadić | Refet Gojak

Journal: Acta Medica Academica
ISSN 1840-1848

Volume: 41;
Issue: 2;
Start page: 145;
Date: 2012;
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Keywords: Interatrial septal defect | Echocardiography | Streched ballon diameter | Amplatzer septal occluder

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 quantificationA-SBD=TTE defect diameter×1:09 + 3.9 mm and A-SBD=1.1× transesophagealdiameter 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 relationto neighbouring structures. The largest diameter was selectedas the reference diameter. Results. Of the total number of treatedpatients, 11 were female. Treatment was conducted by a foreign andlocal team of invasive cardiologists. The average age of the patientswas 8.43 years (2 -17 years). Apart from a transient disturbance ofrhythm 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 determinethe appropriate size needed Amplatzer Septal Occluder device.
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