The reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect.

OBJECTIVE: To determine the reliability of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in predicting the size of an atrial septal defect (ASD). MATERIAL AND METHODS: The study included 16 patients who underwent the catheter-based procedures to close an atrial septal defect between February 2008 and December 2011 at the Paediatrics Clinic, CCU Sarajevo, after clinical and TTE and TEE evaluation. In order to determine the assumed diameter of the balloon (A-SBD), we used the formula of quantification A-SBD=TTE defect diameter×1:09 + 3.9 mm and A-SBD=1.1× transesophageal diameter of ASD+2.0 mm. The ASD was examined using the long-axis view, the basal short-axis view, the apical four-chamber view and the subcostal view to observe its position, diameter and relation to neighbouring structures. The largest diameter was selected as the reference diameter. RESULTS: Of the total number of treated patients, 11 were female. Treatment was conducted by a foreign and local team of invasive cardiologists. The average age of the patients was 8.43 years (2 -17 years). Apart from a transient disturbance of rhythm in the youngest patients, there were no other intra and postprocedural complications. The obtained formulas represent "our" default size of the SBD, based on measurements of TTE and TEE: A-SBD (TTE)=6.02+0.86×TTE and A-SBD (TEE)=3.93+0.86×TEE. CONCLUSION: ASD diameter determined by TTE and TEE can reliably determine the appropriate size needed Amplatzer Septal Occluder device.