Application value of real-time three-dimensional transesophageal echocardiography in multiple atrial septal defect device closure

Niu Baorong; Zhang Chun; li Xiaoming; Wu Shan; Li Linshan

doi:10.3760/cma.j.issn.1673-4777.2016.08.006

Abstract：Objective To explore the application value of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE) in muhiple atrial septal defect (ASD) device closure.Methods Totally 25 cases of ASD device closure from March 2013 to March 2015 in Beijing Anzhen Hospital,Capital Medical University were enrolled,including 14 patients having two-dimensional echocardiography(2D-TEE group) and 11 patients having RT-3D-TEE (3D-TEE group) before operation.Forms,positions,numbers and anatomical adjacencies of defects and the adequacy of septal rims for device closure in two groups were obtained from the 2D-TEE and RT-3D-TEE,respectively.In all patients undergoing transcatheter closure,the intraoperative monitoring and follow-up was conducted by two-dimensional echocardiography.Results All patients were placed Amplatzer septal occluder devices.In 2D-TEE group,all of 14 cases had double ASD(12 cases were diagnosed before operation,2 cases were diagnosed during operation);totally 28 defects were found and 14 Amplatzer occluder devices were successfully placed.In 3D-TEE group,10 cases were diagnosed with double ASD before operation;1 case had triple ASD;totally 23 defects were found;12 Amplatzer occluder devices were successfully placed.The operation time and X-ray time in 3D-TEE group were significantly shorter than those in 2D-TEE group [(42± 3) min vs (47 ± 6) min,(3.5 ± 0.7) min vs (4.6 ± 1.2)min] (P ＜ 0.05).The RT-3D-TEE provided more visual and clear images than 2D-TEE in the evaluation of forms,positions,numbers and anatomical adjacencies of multiple ASD.Conclusions The RT-3D-TEE can provide more accurate informations of forms,positions,numbers and anatomical adjacencies for the diagnosis of multiple ASD,regarding the amounts,shapes,locations,hole pitch and anatomy adjacency of defects than 2D-TEE in patients with ASD.Patients with multiple ASD are suggested to have RT-3D-TEE examination before operations.