Atrial septal defect (ASD) is a common variety of acyanotic congenital heart defects and accounts for a significant portion of the operative volume in a cardiac surgical setup. Transthoracic echocardiography (TTE) has class I recommendation for initial and follow-up assessment of all congenital heart diseases. It has an indispensable role for diagnosis, assessment of hemodynamics as well as ventricular function, and ruling out other associated cardiac anomalies. Transesophageal echocardiography (TEE) is particularly useful for evaluation for transcatheter closure of ASD as well as for guidance during transcatheter or surgical closure of ASD. Three-dimensional echocardiography is now increasingly used for better assessment of ASD location, shape and dimensions, surrounding structures, rims as well as for real-time procedural guidance of percutaneous ASD closure. We provide a discussion on perioperative and peri-interventional transthoracic as well as transesophageal echocardiographic assessment of ASD, directed towards trainee cardiac anesthesia fellows/residents providing perioperative and peri-interventional anesthetic care as well as echocardiographic guidance in the operating room and cardiac catheterization laboratory.
Kapoor R, Gupta S. Prevalence of congenital heart disease, Kanpur, India. Indian Pediatr 2008;45(4):309–311.
Vyas PM, Oswal NK, Patel IV. Burden of congenital heart diseases in a tertiary cardiac care institute in Western India: need for a national registry. Heart India 2018;6(2):45–50. DOI: 10.4103/heartindia.heartindia_3_18
Nashat H, Montanaro C, Li W, et al. Atrial septal defects and pulmonary arterial hypertension. J Thorac Dis 2018;10(Suppl 24):S2953–S2965. DOI: 10.21037/jtd.2018.07.112
Homma S, Sacco R. Patent foramen ovale and stroke. Circulation 2005;112(7):1063–1072. DOI: 10.1161/CIRCULATIONAHA.104.524371
Jain S, Dalvi B. Atrial septal defect with pulmonary hypertension: when/how can we consider closure? J Thorac Dis 2018;10(Suppl 24):S2890–S2898. DOI: 10.21037/jtd.2018.07.112
Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 2019;139(14):e637–e697. DOI: 10.1161/CIR.0000000000000603
Silvestry FE, Cohen MS, Armsby LB, et al. Guidelines for the echocardiographic assessment of atrial septal defect and patent foramen ovale: from the American Society of Echocardiography and Society for Cardiac Angiography and Interventions. J Am Soc Echocardiogr 2015;28(8):910–958. DOI: 10.1016/j.echo.2015.05.015
Lai WW, Geva T, Shirali GS, et al. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006;19(12):1413–1430. DOI: 10.1016/j.echo.2006.09.001
Bezold LI. Atrial abnormalities and atrial septal defects. In: Wong PC, Miller-Hance WC, editors. Transesophageal Echocardiography for Congenital Heart Disease. London: Springer-Verlag; 2014. pp. 171–192. DOI:10.1111/j.1540-8175.1991.tb01019.x
Chockalingam A, Dass S, Alagesan R, et al. Role of transthoracic Doppler pulmonary venous flow pattern in large atrial septal defects. Echocardiography 2005;22(1):9–13. DOI: 10.1111/j.0742-2822.2005.03171.x
Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. J Am Soc Echocardiogr 2010;23(7):685–713.
Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010;23(5):465–467. DOI: 10.1016/j.echo.2010.03.019
Wang YC, Huang CH, Tu YK. Pulmonary hypertension and pulmonary artery acceleration time: a systematic review and meta-analysis. J Am Soc Echocardiogr 2018;31(2):201–210. DOI: 10.1016/j.echo.2017.10.016
Granstam SO, Björklund E, Wikström G, et al. Use of echocardiographic pulmonary acceleration time and estimated vascular resistance for the evaluation of possible pulmonary hypertension. Cardiovasc Ultrasound 2013;11:7. DOI: 10.1186/1476-7120-11-7
Abbas AE, Fortuin FD, Schiller NB, et al. A simple method for noninvasive estimation of pulmonary vascular resistance. J Am Coll Cardiol 2003;41(6):1021–1027. DOI: 10.1016/s0735-1097(02)02973-x
Puchalski MD, Lui GK, Miller-Hance WC, et al. Guidelines for performing a comprehensive transesophageal echocardiographic: examination in children and all patients with congenital heart disease: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2019;32(2):173–215. DOI: 10.1016/j.echo.2018.08.016
Ammash NM, Seward JB, Warnes CA, et al. Partial anomalous pulmonary venous connection: diagnosis by transesophageal echocardiography. J Am Coll Cardiol 1997;29(6):1351–1358. DOI: 10.1016/s0735-1097(97)82758-1
Lopez PP, Rodriguez CG, Gonzalez AG, et al. Pulmonary vein stenosis: etiology, diagnosis and management. World J Cardiol 2016;8(1):81–88. DOI: 10.4330/wjc.v8.i1.81
Simpson J, Lopez L, Acar P, et al. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography J Am Soc Echocardiogr 2017;30(1):1–27. DOI: 10.1016/j.echo.2016.08.022
Saric M, Perk G, Purgess JR, et al. Imaging atrial septal defects by real-time three-dimensional transesophageal echocardiography: step-by-step approach. J Am Soc Echocardiogr 2010;23(11):1128–1135. DOI: 10.1016/j.echo.2010.08.008
Mahmoud HM, Al-Ghamdi MA, Ghabashi AE, et al. A proposed maneuver to guide transseptal puncture using real-time three-dimensional transesophageal echocardiography: pilot study. Cardiol Res Pract 2015;Article ID 174051. DOI: 10.1155/2015/174051