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Updated: Mar 14, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Real time three-dimensional transesophageal echocardiography imaging of crescent-shaped superior sinus venosus atrial
Yegyu Sung1, Jung Sun Cho1, Ho-Joong Youn1
1Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul, Korea.
Insights
Multi-imaging is crucial for diagnosing atrial septal defects (ASDs) when right ventricular enlargement is disproportionate. Real-time 3D transesophageal echocardiography effectively identified a superior sinus venosus ASD, confirmed by MDCT.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Atrial septal defects (ASDs) can cause right ventricular enlargement.
- Conventional transthoracic echocardiography may underestimate ASD size.
- Advanced imaging is needed for complex cases.
Observation:
- A patient presented with unexplained right ventricular enlargement despite a small ASD on conventional echocardiography.
- Crescent-shaped superior sinus venosus ASD was suspected.
- Real-time three-dimensional transesophageal echocardiography (3D-TEE) was employed for detailed visualization.
Findings:
- 3D-TEE successfully discriminated the crescent-shaped superior sinus venosus ASD.
- Multi-detector computed tomography (MDCT) confirmed the ASD's anatomical relationship with the superior vena cava.
- MDCT ruled out associated anomalies, including pulmonary venous return anomalies.
Implications:
- This case highlights the utility of multi-imaging modalities in diagnosing challenging ASDs.
- 3D-TEE offers superior visualization for specific ASD types.
- Accurate diagnosis is essential for appropriate management and surgical planning of atrial septal defects.
Abstract:
Multi-imaging modalities should be considered in patients with atrial septal defects (ASDs) in which the degree of right ventricular enlargement is not fully explained by the small size of ASD found on conventional transthoracic echocardiography. We report a case of crescent-shaped superior sinus venosus ASD discriminated using real-time three-dimensional transesophageal echocardiography. MDCT confirmed its relationship with the superior vena cava and the absence of combined anomalies, such as the pulmonary venous return anomaly.
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