Intracardiac ultrasound assessment of atrial septal defect: Comparison with transthoracic echocardiographic, angiocardiographic, and balloon-sizing measurements

Purpose: Accurate evaluation of the size, location and adjacent structure o f an atrial septal defect (ASD) is very important in the selection of patie nts for further management. We directly compared the utility of transthorac ic echocardiography, angiocardiography, balloon sizing, and intracardiac ul trasound (ICUS) in the detection of ASD. Methods: Twenty-one children underwent an ICUS study of ASD after routine c linical and laboratory studies. All patients had received transthoracic ech ocardiography (TTE), cardiac catheterization, cineangiography, and balloon sizing before the ICUS to evaluate the ASD. Results: There was a significant correlation between the ICUS-derived ASD d iameter and the other methods (p < 0.001). The balloon-sizing diameter was estimated by the equation: TTE diameter x 1.09 + 3.9 mm. There was a good c orrelation between the predicted and measured balloon-sizing diameter (r = 0.963; p < 0.001). Conclusion: It is worthwhile spending a few minutes to perform ICUS during cardiac catheterization since it will provide more detailed information on and high resolution images of atrial septal morphology, especially for pati ents undergoing transcatheter closure by device.