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J Cardiovasc Comput Tomogr. 2015 Jul-Aug;9(4):354-61. doi: 10.1016/j.jcct.2015.04.007. Epub 2015 May 1.

Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT.

Author information

1
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama 700-8558, Japan.
2
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama 700-8558, Japan. Electronic address: miyoshit@cc.okayama-u.ac.jp.
3
Department of Radiology, Okayama University Hospital, Okayama, Japan.
4
Division of Cardiac Intensive Care Unit, Okayama University Hospital, Okayama, Japan.
5
Center of Ultrasonic Diagnostics, Okayama University Hospital, Okayama, Japan.

Abstract

BACKGROUND:

Cardiac CT is an excellent tool for evaluating the anatomy of a secundum atrial septal defect (ASD). However, a comprehensive assessment of its usefulness, including measurement of the pulmonary to systemic blood flow ratio in secundum ASD patients, has not been performed.

OBJECTIVE:

Therefore, this study was designed to evaluate the usefulness of CT for assessing the hemodynamics of secundum ASD in adults compared with transesophageal echocardiography (TEE), transthoracic echocardiography, and invasive catheterization.

METHODS:

Fifty adult patients with secundum ASD were enrolled. Cardiac CT scans (128-slice multidetector CT instrument) were acquired. These were followed by 2-dimensional reconstruction of the secundum ASDs to determine the defect size, the rim length between the outer edge of the defect, and the pulmonary to systemic blood flow (Qp/Qs) ratio.

RESULTS:

The maximum sizes of the secundum ASDs derived from CT and TEE studies were comparable (21.2 ± 8.0 vs. 20.0 ± 7.3 mm; P = .41; r = 0.960; P < .001). The rim lengths for the aortic, mitral, and tricuspid valves; the inferior vena cava; and posterior atrium were also comparable between CT and TEE measurements. The mean Qp/Qs ratio that was derived from CT measurements was comparable with that found by invasive catheterization (2.3 ± 0.7 vs. 2.3 ± 0.8; P = .73; r = 0.786; P < .001).

CONCLUSION:

Cardiac CT is feasible for assessing pathology and the severity of secundum ASD in adults.

KEYWORDS:

Atrial septum defect; Cardiac computed tomography; Congenital heart disease; Echocardiography; Structural heart disease

PMID:
26088383
DOI:
10.1016/j.jcct.2015.04.007
[Indexed for MEDLINE]

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