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Updated: Aug 21, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Three-dimensional color Doppler echocardiography for assessing shunt volume in atrial septal defects
Thomas Hofmann1, Olaf Franzen, Dietmar H Koschyk
1Universitätsklinikum Hamburg-Eppendorf, Medizinische Klinik III, Hamburg, Germany. thofman@uke.uni-hamburg.de
Insights
Three-dimensional color Doppler echocardiography accurately assesses transatrial shunt flow in atrial septal defect patients. This advanced technique provides reliable measurements in a clinical setting, aiding diagnosis and treatment planning.
Area of Science:
- Cardiology
- Medical Imaging
- Fluid Dynamics
Background:
- Three-dimensional color Doppler echocardiography (3D-CDE) is established for experimental cardiac blood flow assessment.
- Its clinical applicability for evaluating transatrial shunt flow in atrial septal defects (ASDs) remains to be validated.
Purpose of the Study:
- To evaluate the feasibility and accuracy of transesophageal 3D-CDE for quantifying shunt flow in patients with ASDs in a clinical setting.
Main Methods:
- 46 consecutive ASD patients underwent shunt flow assessment via cardiac catheterization (Fick method) and conventional 2-D transesophageal Doppler echocardiography (2D-TEDE) as reference.
- Transesophageal 3D-CDE was employed to analyze the 3D flow velocity field of transatrial shunt flow.
- Shunt volume was calculated using the Gauss theorem applied to the 3D flow data.
Main Results:
- A strong correlation was observed between shunt volumes measured by 3D-CDE and the reference methods (r = 0.981, P < .001).
- The 95% confidence intervals for predicting reference values from 3D-CDE data were -11.5% to +11.6%.
Conclusions:
- Transesophageal 3D-CDE is a clinically viable and accurate method for assessing transatrial shunt flow in patients with ASDs.
- This technique offers a non-invasive approach to quantify shunt volumes, potentially improving diagnostic capabilities.
Abstract:
Background Three-dimensional color Doppler echocardiography has been used to assess cardiac blood flow in experimental settings. We tested whether this technique can be applied to assess transatrial shunt flow in patients with atrial septal defect in a clinical setting. Methods In 46 consecutive patients with atrial septal defects, shunt flow was assessed during cardiac catheterization using the Fick method and by conventional 2-D quantitative transesophageal Doppler echocardiography. The averaged values for shunt flow obtained by both methods were used as a reference. Transesophageal 3-D color Doppler echocardiography was performed for analysis of the 3-D flow velocity field of transatrial shunt flow. Shunt volume was calculated by application of the Gauss theorem. Results We found a close correlation between shunt volume (L/min) obtained by either 3-D color Doppler echocardiography or the reference methods ( r = 0.981, P < .001). Using 3-D color Doppler data to predict the reference values, 95% confidence limits were -11.5 to +11.6%. Conclusions Shunt flow in patients with atrial septal defects can be assessed in a clinical setting by transesophageal 3-D color Doppler echocardiography.
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