ĐỐI CHIẾU KÍCH THƯỚC LỖ THÔNG LIÊN NHĨ TRÊN SIÊU ÂM 2D/3D QUA THỰC QUẢN VỚI ĐƯỜNG KÍNH EO CỦA DỤNG CỤ BÍT LỖ THÔNG LIÊN NHĨ TRÊN THÔNG TIM

Abstract

Background: The assessment of interatrial septum (ISA) requires a standardized, systematic approach, including two-dimensional transthoracic echocardiography (2D TTE), 2D transesophageal echocardiography (2D TEE), and three-dimensional (3D) TEE. The introduction of 3D TEE provides a unique “en face” view of IAS, which allows the visualization and accurate measurements of diameters, area, and rims of ASD. Hence, appropriate ASD imaging information is particularly important in successful transcatheter closure. Aims: To compare size of ASD assessed with 2D/3D transesophageal echocardiography and size of occlusion device (Amplatzer) on catetherization. Method: Patients with secundum ASD were included in th e study. 2D TEE, and 3D TEE were performed before ASD closure, with 2D minimal and maximal diameters recorded. Adequate 3D TEE imaging data sets were collected and then analyzed. ASD related parameters and size of occlusion device (Amplatzer) were compared using different echocardiography. Results:  From 9/2017 to 8/2018, 58 patients diagnosed with secundum ASD were included in the study. All patients underwent 2D/3D TEE. 54 patients had ASD occlusion with Amplatzer. 4 patients were operated because of large ASD. The mean diameter of ASD measured by 2D TEE was 21,06±6,11mm, by 3D TEE was 22,09±5,18mm, by ballon sizing on catheterization was 31,52±5,68mm.  There was a dynamic change of ASD diameter during the cardiac cycle: the maximal diameter (23,75±5,63mm) was observed at end atrial dilation (ventricular systole) and the minimal diameter (17,34±5,87mm) was observed at end atrial contraction (ventricular diastole). The agreement between ASD size by 3D TEE and Amplazer size was more apparent than 2D TEE (p<0.05). Conclusion: Our study confirms the value of 3D TEE in assessing ASD size in comparision with Amplatzer size by ballon sizing.