Perioperative Echocardiographic Assessment of Atrial Septal Defect: Key Learning Points for Fellows/Residents in Training

摘要

Atrial septal defect (ASD) is a common variety of acyanotic congenital heart defects and accounts for a significant portion of the operative volume in a cardiac surgical setup. Transthoracic echocardiography (TTE) has class I recommendation for initial and follow-up assessment of all congenital heart diseases. It has an indispensable role for diagnosis, assessment of hemodynamics as well as ventricular function, and ruling out other associated cardiac anomalies. Transesophageal echocardiography (TEE) is particularly useful for evaluation fortranscatheter closure of ASD as well as for guidance during transcatheter or surgical closure of ASD.Three-dimensional echocardiography is now increasingly used for better assessment of ASD location, shape and dimensions, surrounding structures, rims as well as for real-time procedural guidance of percutaneous ASD closure. We provide a discussion on perioperative and peri-interventional transthoracic as well as transesophageal echocardiographic assessment of ASD, directed towards trainee cardiac anesthesia fellows/residents providing perioperative and peri-interventional anesthetic care as well as echocardiographic guidance in the operating room and cardiac catheterization laboratory.