Characterization of atrial septal defect assessed by real-time 3-dimensional echocardiography.

Objective: The aim of this study was to describe a quantitative evaluation by real-time 3-dimensional (3D) echocardiography (RT-3DE) of atrial septal defect (ASD) and atrial septum that is important for patient selection for transcatheter closure, and to assess the reliability of RT-3DE findings compared with operation.

Methods: Forty-five patients, who were scheduled for surgical or transcatheter closure of an ASD, were included in the study.

Results: In 43 patients (96%), 3D reconstructions allowed optimal imaging of the ASD. The correlations between the ASD maximal diameter by RT-3DE and operation or balloon sizing were excellent (r > 0.95). All surrounding rims of the atrial septum could be assessed on 3D reconstruction; except for the aortic rim, a cross-sectional reconstruction was created mimicking the transesophageal echocardiographic cross section (r > 0.92).

Conclusion: RT-3DE allows accurate determination of ASD location, ASD size, and surrounding tissue of the atrial septum, and might replace transesophageal echocardiography for patient selection for surgical or transcatheter closure.