Dreidimensionale Rekonstruktion transösophagealer zweidimensionaler Schnittbilder zur quantitativen Analyse von Vorhofseptumdefekten vom Sekundum-Typ

A non-invasive method for the determination of size and spatial relationships of the atrial septal defects to adjacent cardiac structures, which would be advantageous to those contemplating device closure, is described. The aim was to examine the value of the transesophageal threedimensional echocardiography for this purpose. Three-dimensional reconstruction of transesophageal echocardiography was performed in 17 patients. Left-to-right shunt (by oxymetrie in 16 of the 17 patients) was 2.4 to 16.2 L/min, and the QP/QS ratio was 1.4 to 4.7. The defect area of the atrail septal defect was measured throughout the whole cardiac cycle each 40 ms using two-dimensional stop frame images generated from the three-dimensional data set. Results were compared with shunt parameters by oxymetrie and with intraoperative measurements. Distances between the atrial septal defect and mitral and tricuspid annulus and the orifices of the caval and pulmonary veins were also measured. The atrial septal defect area ranged from 0.2 to 2.4 cm2 (diastole) to 0.5 to 5.6 cm2 (systole). The maximal area at end-systole was 108% of the area at the beginning of the systole, and the minimal area at end-diastole was 43%. The defect area correlated significantly with the QP/QS ratio (r = 0.7), and the maximal atrial septal defect diameters as measured by using three-dimensional echocardiography correlated well with intraoperative measurements (r = o.87). Distances to mitral and tricuspid annulus and to the superior caval vein were determined in all patients. Distances to the orifice of the inferior caval vein were measured in 12 patients, and the orifices of right pulmonary veins were visible in 5 paitents. Transesophageal three-dimensional echocardiography of atrial septal defects allows the determination of the instantaneous defect area and its dynamic changes and thus provides valuable information about the distances to adjacent cardiac structures. This may have clinical implications for the selection of patients suitable for interventional closure and for the assessment of procedural success.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2001

Author dc:creator

• Rulands, Dierk

Contributors dc:contributor

• Hanrath, Peter

• info:eu-repo/classification/ddc/610
• Medizin

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-118954%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A56877