Real-time three-dimensional transesophageal echocardiography in @entity1 with secundum XXXX : outcomes following transcatheter closure.

@entity1 @entity118 @entity7085 @entity2438
BACKGROUND: Successful transcatheter closure of @entity118 ( @entity118 ) requires the accurate assessment of defect size and morphology. Assessment of @entity2438 anatomy may be difficult by two-dimensional (2D) echocardiography. The aim of this study was to test the hypothesis that real-time three-dimensional (3D) transesophageal echocardiography (TEE) may provide more accurate morphologic assessment of @entity118 than multiplane 2D TEE. METHODS: Twenty-four @entity1 with @entity118 were imaged using 2D and real-time 3D TEE. @entity2438 shape and size were assessed using 3D TEE retrospectively. Maximal @entity2438 dimensions obtained by 3D TEE were compared with unstretched and balloon-stretched dimensions on 2D TEE. Planimetered defect area by 3D TEE was compared with area calculated using the @entity7085 formula from 2D imaging. Twenty of the 24 @entity1 underwent transcatheter @entity2438 closure. Closure device size was based on findings on 2D TEE. Follow-up was conducted by 2D transthoracic echocardiography. RESULTS: Of the 24 @entity118 , 6 (25%) were circular, 10 (42%) were oval, and 8 (33%) were complex in shape. The mean maximal dimension was larger by 3D TEE compared with 2D TEE (1.8    0.8 vs 1.5    0.6 cm; P < .05). There was no difference in the mean area measured by either modality, but for complex-shaped defects, area measured by 3D TEE was larger than that by 2D TEE (2.8    1.3 vs 1.7    1.4 cm(2); P < .05). Follow-up transthoracic echocardiography was available for 19 of the 20 @entity1 undergoing transcatheter closure. Nine @entity1 had residual right-to-left shunting 1 to 6 months after @entity2438 closure, and the majority of these were complex in shape. In @entity1 with residual shunting, @entity2438 area by 3D TEE was 27% larger than by 2D TEE, whereas in @entity1 without residual shunting, there was significantly less discrepancy between 3D and 2D areas (19%; P  = .0027). CONCLUSIONS: Three-dimensional TEE can identify @entity2438 shape. Maximal dimensions on 3D TEE were well correlated with balloon-stretched 2D dimensions. Two-dimensional TEE can underestimate the area of complex-shaped @entity118 , which may result in residual right-to-left shunting.
