Clinical Study Of Real-time 3-Dimensional Echocardiography In Diagnosis And Intervention Of Atrial Septal Defect

【Background】To evaluate the clinical application of real-time 3-dimensional echocardiography(RT-3DE) in diagnosis of secundum atrial septal defects(SASD) and in transcatheter closure of atrial septal defect(TCASD).【Methods】37 patients with ASD(23males,14females;mean age 31.6±10.2 years, range 15 years to 52 years) in the 1^st affiliated hospital and the affiliated Yan-An hospital of Kunming medical college,were examined with transthoracic echocardiography(TTE),transesophageal echocardiography(TEE),real-time 3-dimensional transthoracic echocardiography(RT-3D-TTE) and real-time 3-dimensional transesophageal echocardiography(RT-3D-TEE).The maximum sizes of ASD measured by each method were compared with the diameters of ASO repectively.Meanwhile the shapes and distandes between ASD and superior vena cava(SVC),inferior vena cava(IVC),right upper pulmonary vein(RUPV) and mitral valve annulus(MVA),were observed and recorded.TCASD underwent under the monitoring and guidance of different ultrasonic methods.【Results】36 patients were examined by all the ultrasonic methods,1 quit from the TEE and RT-3D-TEE.36 cases were enrolled for TCASD.successfully,1 transferred for surgery because of its absent rim of IVC.No residual shunt was found immediately after the procedure,neither during 3 days to 3 months follow-up.All ASO were functioning well.During TCASD procedure,25 cases monitored and guided by RT-3D-TTE and TTE while 11 cases by and TEE.There were correlations between diameters of ASO and sizes of ASD measured by RT-3D-TEE(r:0.754) and those by TEE(r:0.692),and the former one was higher.Both regression equations were abtained.【Conclusion】RT-3D-TEE plays a significant role in the selectin of ASO preoperation,the observation of rims of ASD,and monitoring and guidance of deployment of ASO.It is a potentially valuable tool for TCASD.