Feasibility Study Of Real-time Three-dimensional Echocardiography In Guiding Transcatheter Closure Of Atrial Septal Defects

【Objective】To Evaluation the value on transthoracic real-time three-dimensional transesophageal echocardiography(RT-3D-TTE) in diagnosis of atrial septal defects(ASD) and in selection of atrial septal defect occluder(ASO) and in independently guiding transcatheter closure.【Methods】21 patients(males 7,females 14;mean age 12±14 years,range 3 years 44 to years) with ASD and wiithout contraindications were diagnosed by two-dimensional ultrasound and RT-3D-TTE,use the panoramic of the ASD with 3D viewing to understand morphology and to measures areas. The whole process of operation were guided by RT-3D-TTE as well as fluoroscopy and evaluate the postoperation effect. The correlation between the maximum diameter of the closure waist and defect area were studied.【Results】All the patients were obtained accepted images and all the operations were held successfully. ASO fit closely together to the edge of ASD.No residual shunt was found immediately after the proceduce,neither during 3 days to 3 mounths follow-up.Transthoracic RT-3D-TTE could clearly display shape,size,position of ASD and the occluder release process.Understand defect morphology and measure defect area with RT-3D-TTE have instructional significance for occluder selection(paided t test,p=0.67).This difference in RT-3D-TTE guiding and x-ray guiding was not statistically significant(chi-square test,p>0.05).【Conclusion】The method of transthoracic RT-3D-TTE and 2D-TTE in closure of ASD is feasible on the clear ultrasound image premise,it can avoid the radiation of x-ray,it has application value.