Cross-Sectional Echocardiographic Study on Atrial Septal Defect : Pre- and Postoperative Considerations

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The interatrial septum (IAS) has not been readily appreciated by M-mode echocardiography, but cross-sectional echocardiography has the capability of recording the shape and location of the IAS.Thirty-five patients with secundum atrial septal defect (ASD) were studied with cross-sectional echocardiography for detection of the ASD defect and demonstration of the IAS features following ASD closure.The ASD was shown as an echo dropout at the mid-portion of the septum in those patients examined in the present study in the horizontal cross-sections at the fourth intercostal space. The edges of the remaining IAS sharply demarcated and the defect was constantly demonstrated. In the postoperative patients, the IAS was recognized as a smooth series of echoes and the defect was no longer recognized. A notch echo was demonstrated in patients who underwent direct suture of the defect, and two notch echoes were recorded in patients who had a patch closure from a cardiac operation.The size of the defect at cardiac operation ranged from 1.5 to 5.0cm with an average of 3.3±0.2cm. The defect was slightly smaller on cross-sectional echocardiograms than at the time of operation. As the defect grew larger, the right ventricular dimension and the Qp/Qs became larger as well. Postoperatively, the right ventricular dimension was remarkably decreased, and the paradoxical movement of the interventricular septum (IVS) was normalized in the majority of the patients.Cross-sectional echocardiography is useful to diagnose ASD, to measure the size of the IAS defect, and to follow the clinical course.
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Cross-Sectional Echocardiographic Study on Atrial Septal Defect : Pre- and Postoperative Considerations

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