A Picture is Worth a Thousand Words
Transesophageal Echocardiographic Images of Atrial Septal Defect Device Closure Monish S. Raut, Arun Maheshwari Department of Cardiac Anesthesia, Dharam Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
Figure 1: Transesophageal echocardiographic examination
bicaval view showing ASD. LA: Left atrium, RA: Right atrium, ASD: Atrial septal defect
Figure 2: Transesophageal echocardiographic examination
bicaval view showing atrial septal defect with shunting of blood from the left atrium to the right atrium
Figure 3: Transesophageal echocardiographic examination 4
chamber view showing atrial septal defect device closure
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Address for correspondence: Dr. Monish S. Raut,
Department of Cardiac Anesthesia, Dharam Vira Heart Center, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi ‑ 110 060, India. E‑mail:
[email protected] HEART VIEWS Jan-Mar 15 Issue 1 / Vol 16
DOI: 10.4103/1995-705X.153003
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Raut and Maheshwari: TEE in ASD device closure
Figure 4: Transesophageal echocardiographic examination bicaval view showing atrial septal
defect closure device with good positioning
Figure 5: Transesophageal echocardiographic examination bicaval view showing stable
positioning of the device with no shunting through the device
A
40‑year‑old male patient with symptoms of shortness of breath was diagnosed as ostium secundum atrial septal defect (ASD). Patient was posted for ASD device closure in cardiac cath lab. Transesophageal echocardiographic examination (TEE) was performed, which showed ostium secundum ASD of 24 mm size with left to right shunt and good rim size of interatrial septum [Figures 1 and 2]. ASD device closure was done through right femoral approach. After the procedure device closing, the defect could be seen with no shunting of blood [Figures 3‑5]. TEE, in cardiac cath lab, has the added advantage of assessing ASD size and magnitude of shunt. With the help of TEE, superior and inferior rim of ASD can be accurately measured. Proper deployment of device discs can be verified by TEE. TEE can act as adjuvant to fluoroscopy in ASD device closure procedure in cath lab.
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