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Subcostal real-time three-dimensional echocardiography of interatrial communications: reconstruction of an oval fossa defect, a superior sinus venosus defect with partially anomalous pulmonary venous drainage, an infero-posterior oval fossa defect, and a coronary sinus defect

Published online by Cambridge University Press:  19 August 2011

Karolina M. G. Bilska ,
Claudia M. J. Kehrens ,
Gillian Riley ,
Robert H. Anderson  and
Jan Marek
Karolina M. G. Bilska
Affiliation:
Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom
Claudia M. J. Kehrens
Affiliation:
Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom
Gillian Riley
Affiliation:
Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom
Robert H. Anderson
Affiliation:
Institute of Child Health, University College London, United Kingdom
Jan Marek*
Affiliation:
Department of Cardiology, Great Ormond Street Hospital for Children, London, United Kingdom
*
Corresponding author. Dr. J. Marek, MD, PhD, Director of Echocardiography, Consultant Paediatric Cardiologist, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom. Tel: +02074059200/Ext 8012; Fax: +44 207 813 8262; E-mail: [email protected]
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Abstract

Real-time three-dimensional echocardiography can surpass simple cross-sectional echocardiography in providing precise details of cardiac lesions. For the purpose of optimising treatment, we describe our findings with real-time three-dimensional echocardiography when interrogating different types of communications permitting interatrial shunting. A three-dimensional reconstruction of defects within the oval fossa enabled reliable identification of location, size, and integrity of surrounding rims. In the superior sinus venosus defect associated with partially anomalous pulmonary venous drainage, three-dimensional reconstruction helped to provide a better understanding of the relationship between the interatrial communication, the orifice of the superior caval vein, and the connections of the right upper pulmonary vein. In the defect opening infero-posteriorly within the oval fossa, three-dimensional reconstruction helped to avoid the risk of potentially inappropriate closure of the defect by suturing the hyperplastic Eustachian valve to the atrial wall, which could have diverted the inferior caval venous return into the left atrium, or obstructed the caval venous orifice. In the coronary sinus defect, three-dimensional echocardiography provided a ‘face to face’ view of the entire coronary sinus roof, showing a circular defect communicating with the cavity of the left atrium. Acquisition of the full-volume data sets took less than 2 minutes for the patients having defects within the oval fossa, and no more than 3 minutes for the patients with the sinus venosus and coronary sinus defects. Post-processing for the defects in the oval fossa took from 5 to 8 minutes, and from 12 to 16 minutes for the more complicated defects.

Conclusion

Cross-sectional two-dimensional echocardiography can establish correct diagnosis in all types of atrial communications; however, real-time three-dimensional reconstruction provides additional value to the surgeon and interventionist for better understanding of spatial intracardiac morphology.

Keywords

Atrial communicationsreal-time three-dimensional echocardiographyatrial septal defect
Type
Original Articles
Information
Cardiology in the Young , Volume 22 , Issue 2 , 02 March 2012 , pp. 145 - 151
Copyright
Copyright © Cambridge University Press 2011

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References

1.Van den Bosch, AE, Ten Harkel, DJ, McGhie, JS, et al. Characterization of atrial septal defect assessed by real-time 3-dimensional echocardiography. J Am Soc Echocardiogr 2006; 19: 815–821.CrossRefGoogle ScholarPubMed
2.Zhu, W, Cao, QL, Rhodes, J, Hijazi, ZM. Measurement of atrial septal defect size: a comparative study between three-dimensional transesophageal echocardiography and the standard balloon sizing methods. Pediatr Cardiol 2000; 21: 465–469.CrossRefGoogle Scholar
3.Suematsu, Y, Takamoto, S, Kaneko, Y, et al. Beating atrial septal defect closure monitored by epicardial real-time three-dimensional echocardiography without cardiopulmonary bypass. Circulation 2003; 107: 785–790.CrossRefGoogle ScholarPubMed
4.Handke, M, Heinrichs, G, Moser, U, et al. Transesophageal real-time three-dimensional echocardiography methods and initial in vitro and human in vivo studies. J Am Coll Cardiol 2006; 48: 2070–2076.CrossRefGoogle ScholarPubMed
5.Suematsu, Y, Kiaii, B, Bainbridge, DT, del Nido, PJ, Novick, RJ. Robotic-assisted closure of atrial septal defect under real-time three-dimensional echo guide: in vitro study. Eur J Cardiothorac Surg 2007; 32: 573–576.CrossRefGoogle ScholarPubMed
6.Roman, KS, Nii, M, Golding, F, Benson, LN, Smallhorn, JF. Images in cardiovascular medicine. Real-time subcostal 3-dimensional echocardiography for guided percutaneous atrial septal defect closure. Circulation 2004; 109: e320–e321.CrossRefGoogle ScholarPubMed
7.Chen, FL, Hsiung, MC, Hsieh, KS, Li, YC, Chou, MC. Real time three-dimensional transthoracic echocardiography for guiding Amplatzer septal occluder device deployment in patients with atrial septal defect. Echocardiography 2006; 23: 763–770.CrossRefGoogle ScholarPubMed
8.Beerman, LB, Zuberbuhler, JR. Atrial septal defects. In: Anderson RH, Baker EJ, McCartney FJ, Rigby ML, Shinebourne EA, Tynan M (eds). Paediatric Cardiology. London: Churchill Livingstone; 2002, p 902.Google Scholar
9.Morishita, Y, Yamashita, M, Yamada, K, Arikawa, K, Taira, A. Cyanosis in atrial septal defect due to persistent Eustachian valve. Ann Thorac Surg 1985; 40: 614–616.Google Scholar
10.Becker, A, Buss, M, Sebening, W, Meisner, H, Döhlemann, C. Acute inferior cardiac inflow obstruction resulting from inadvertent surgical closure of a prominent Eustachian valve mistaken for an atrial septal defect. Pediatr Cardiol 1999; 20: 155–157.Google Scholar
11.Acar, P, Arran, S, Paranon, S. Unroofed coronary sinus with persistent left superior vena cava assessed by 3D echocardiography. Echocardiography 2008; 25: 666–667.CrossRefGoogle ScholarPubMed
12.Chen, FL, Hsiung, MC, Nanda, N, Hsieh, KS, Chou, MC. Real time three-dimensional echocardiography in assessing ventricular septal defects: an echocardiographic-surgical correlative study. Echocardiography 2006; 23: 562–568.CrossRefGoogle ScholarPubMed
13.van den Bosch, AE, Ten Harkel, DJ, McGhie, JS, et al. Surgical validation of real-time transthoracic 3D echocardiographic assessment of atrioventricular septal defects. Int J Cardiol 2006; 112: 213–218.Google Scholar
14.Morgan, GJ, Casey, F, Craig, B, Sands, A. Assessing ASDs prior to device closure using 3D echocardiography. Just pretty pictures or a useful clinical tool? Eur J Echocardiogr 2008, [Epub ahead of print].Google ScholarPubMed
15.Sivasankaran, S, Harikrishnan, S, Narayanan, N, Jaganmohan, T. Laceration of atrial septum during balloon sizing of atrial septal defects. Eur J Echocardiogr 2007; 8: 89–90.CrossRefGoogle Scholar