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Comparison of defect size measured by transthoracic and transesophageal echocardiography with balloon occlusive diameter measured during transcatheter closure of atrial septal defect

Korean Journal of Pediatrics 2007;50(10):970-975.
Published online October 15, 2007.
Comparison of defect size measured by transthoracic and transesophageal echocardiography with balloon occlusive diameter measured during transcatheter closure of atrial septal defect
Kyong Hur1, Jeong Eun Kim1, Yuria Kim2, Hae Sik Kwon1, Byung Won Yoo1, Jae Young Choi1, Jun Hee Sul1
1Division of Pediatric Cardiology, Yonsei Cardiovascular Center Yonsei University College of Medicine, Seoul, Korea
2Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
경피적 심방중격결손 폐쇄술 시 경흉부 및 경식도 초음파 검사 상의 결손의 크기와 풍선 폐쇄 직경과의 관계
허경1, 김정은1, 김유리아2, 권해식1, 유병원1, 최재영1, 설준희1
1연세대학교 의과대학 심장혈관병원 소아심장과
2국민건강보험공단 일산병원 소아과
Correspondence: 
Jae Young Choi, Email: cjy0122@yuhs.ac
Abstract
Purpose
: Accurate measurement of defect size is important in transcatheter closure of atrial septal defect (ASD). We performed this study to analyze the difference between the measured ASD size and balloon occlusive diameter (BOD) by transthoracic (TTE) or transesophageal echocardiography (TEE).
Methods
: We investigated 78 patients who underwent transcatheter closure of ASD. The defect size and the distance between the surrounding structures were measured by TTE and TEE. The BOD was measured by TEE during cardiac catheterization. Clinical characteristics and echocardiographic data were compared and analyzed.
Results
: The difference between BOD and diameter by TTE was 4.8?.6 mm on short axis view, 5.4?.2 mm on long axis view. The difference between BOD and diameter by TEE was 3.6?.2 mm on short axis view, 4.2?.1 mm on long axis view. The difference between BOD and the diameter of defects on TTE, TEE had statistically significant positive correlations with the age of the patients, distance between the, defect and posterior atrial septal wall, the distance between the defect and the mitral valve leaflet, and the diameter of defects and the length of the atrial septum on TTE (P<0.05).
Conclusion
: BOD of ASD can be estimated by the diameter on TTE and TEE. BOD is expected to measure larger, depending on the size of defects, the distance from surrounding structures and the location of defects on echocardiography. Our data offers important information on details of transcatheter ASD closure which can be helpful in predicting suitability and judging the procedural appropriateness during the procedure.
Key Words: Atrial septal defect, Transthoracic echocardiography, Transesophageal echocardiography


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