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Updated: Aug 7, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Characterization of atrial septal defect assessed by real-time 3-dimensional echocardiography
Annemien E van den Bosch1, Derk-Jan Ten Harkel, Jackie S McGhie
1Department of Cardiology, Erasmus MC University Hospital, Rotterdam, The Netherlands. a.e.vandenbosch@erasmusmc.nl
Objective:
The aim of this study was to describe a quantitative evaluation by real-time 3-dimensional (3D) echocardiography (RT-3DE) of atrial septal defect (ASD) and atrial septum that is important for patient selection for transcatheter closure, and to assess the reliability of RT-3DE findings compared with operation.
Methods:
Forty-five patients, who were scheduled for surgical or transcatheter closure of an ASD, were included in the study.
Results:
In 43 patients (96%), 3D reconstructions allowed optimal imaging of the ASD. The correlations between the ASD maximal diameter by RT-3DE and operation or balloon sizing were excellent (r > 0.95). All surrounding rims of the atrial septum could be assessed on 3D reconstruction; except for the aortic rim, a cross-sectional reconstruction was created mimicking the transesophageal echocardiographic cross section (r > 0.92).
Conclusion:
RT-3DE allows accurate determination of ASD location, ASD size, and surrounding tissue of the atrial septum, and might replace transesophageal echocardiography for patient selection for surgical or transcatheter closure.
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