Transesophageal Doppler color flow mapping assessment of atrial septal defect

Department of Medicine, University of Alabama, Birmingham.

Transesophageal Doppler color flow imaging was performed in 19 adult patients (mean age 35 years) with an atrial septal defect demonstrated by cardiac catheterization or at surgery, or both. The transesophageal study correctly identified and classified 19 of 19 shunts in contrast to 16 of 18 shunts identified by the transthoracic approach. The area of the atrial septal defect was calculated by assuming it to be circular and taking the maximal Doppler color flow jet width at the defect site as its diameter. The pulsed Doppler sample volume was placed parallel to the shunt flow direction at the defect site to obtain the mean velocity and flow duration. From these values, the shunt volume was calculated as a product of the defect area, mean velocity, flow duration and heart rate. The calculated shunt flow volume obtained by transesophageal study showed a good correlation with shunt flow volume (r = 0.91, p less than 0.001) and pulmonary to systemic blood flow ratio (r = 0.84, p less than 0.001) obtained at cardiac catheterization. The size of the defect by transesophageal Doppler color flow mapping correlated fairly well with the size estimated at surgery (r = 0.73, p = 0.004). It is concluded that transesophageal Doppler color flow imaging is useful in the detection and classification of atrial septal defects and in the assessment of shunt volumes.

This article has been cited by other articles:

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., December 2, 2008; 52(23): e143 - e263. [Full Text] [PDF]

				C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al. ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, December 2, 2008; 118(23): e714 - e833. [Full Text] [PDF]

				K. Ak, T. Aybek, G. Wimmer-Greinecker, F. Ozaslan, F. Bakhtiary, A. Moritz, and S. Dogan Evolution of surgical techniques for atrial septal defect repair in adults: A 10-year single-institution experience J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 757 - 764. [Abstract] [Full Text] [PDF]

				T. Shiota, M. Jones, S. Aida, M. Chikada, H. Tsujino, T. El-Kadi, and D. J. Sahn Validation of the accuracy of both right and left ventricular outflow volume determinations and semiautomated calculation of shunt volumes through atrial septal defects by digital color Doppler flow mapping in a chronic animal model J. Am. Coll. Cardiol., August 1, 1999; 34(2): 587 - 593. [Abstract] [Full Text] [PDF]

				G. Holmvang, I. F. Palacios, G. J. Vlahakes, R. E. Dinsmore, S. W. Miller, R. R. Liberthson, P. C. Block, B. Ballen, T. J. Brady, and H. L. Kantor Imaging and Sizing of Atrial Septal Defects by Magnetic Resonance Circulation, December 15, 1995; 92(12): 3473 - 3480. [Abstract] [Full Text]

				R. Arora, N. Jolly, G.S. Kalra, and M. Khalilullah Atrial Septal Defect After Balloon Mitral Valvuloplasty: A Transesophageal Echocardiographic Study Angiology, March 1, 1993; 44(3): 217 - 221. [Abstract] [PDF]