Dynamic changes of atrial septal defect area: new insights by three-dimensional volume-rendered echocardiography with high temporal resolution.

AIMS: The purpose of this study was: (i) to record dynamic changes in the area of atrial septal defects (ASD) during a cardiac cycle, and (ii) to investigate factors which influence ASD dynamics. Implementation of new software modifications allowed the frame rate to be doubled, as compared to usual techniques. METHODS AND RESULTS: Twenty patients were examined using transoesophageal three-dimensional (3D) echocardiography. In 10 patients the 3D dataset was recorded with a frame rate of 25Hz, in another 10 patients with a frame rate of 50Hz. The ASD area was planimetried for each picture and the changes analysed over time. The ASD area showed dynamic changes during the cardiac cycle with an end-systolic maximum and end-diastolic minimum. The influence of the various phases of the cardiac cycle on area changes could be differentiated especially at higher temporal resolution. The relative change in ASD area showed no significant relationship to Q(p)/Q(s)ratio, mean ASD size or heart rate. By contrast, there was a slight inverse correlation to age (r=-0.t45,P <0.05). CONCLUSION: Transoesophageal 3D volume-rendered echocardiography permits quantitative recording of ASD dynamics. The ASD area changes are influenced especially by the various phases of the cardiac cycle.

Myxoma of the mitral valve: diagnosis by 2-dimensional and 3-dimensional echocardiography.

In this report we describe a 39-year-old patient who had left-sided hemiparesis. In search of a source of embolism, we performed transthoracic echocardiography, which did not show any abnormalities. Transesophageal echocardiography revealed a small tumor of the posterior mitral leaflet. Three-dimensional transesophageal echocardiography was subsequently performed and demonstrated more accurate information about the size, the morphology, and the attachment point of the tumor. Furthermore, the reconstruction provided excellent spatial visualization of the pathomorphology of the mitral valve and was a useful addition for optimal preoperative diagnostic management. The tumor was excised, and histologic examination confirmed the myxomatous character of the tumor. Mitral valve myxomas are rare. This is the first case reported of a mitral valve myxoma being visualized by 3D echocardiography.