Application of transthoracic echocardiography and transesophageal echocardiography in preoperative screening of different residual types of atrial septal defect occlusion
Objective To explore the application value of transthoracic echocardiography(TTE)and transesophageal echocardiography(TEE)in preoperative screening of different residual types of atrial septal defect(ASD)occlusion.Methods A retrospective analysis was conducted on the clinical data of 120 ASD patients who received interventional treatment for atrial septal defect at the Second People's Hospital of Liaocheng from January 2020 to December 2021.Patients underwent TTE and TEE examinations before surgery,and were divided into two groups based on the results of the preoperative TTE examination:those with strong echogenicity of the defect margin and swing amplitude＜5 mm were classified as group A(n=60);Patients with fine echoes and a swing amplitude of ≥5 mm at the defect margin were classified as group B(n=60).The study compared the differences in measuring the maximum diameter of atrial septal defect between two groups of patients using TIE and TEE,and evaluated the correlation between the maximum diameter of the defect measured by these two methods and the waist diameter of the occluder.Results There was no statistically significant difference in the maximum diameter of atrial septal defect measured by TTE and TEE in group A(P＞0.05),while there was a statistically significant difference in group B(P＜0.01).In group A patients,the correlation between the maximum diameter of ASD measured by TTE and TEE and the diameter of the occluder waist was good(r=0.993,0.991);In group B patients,the correlation between the maximum diameter of ASD measured by TEE and the diameter of the occluder waist was higher(r=0.995),significantly greater than the correlation with TIE measurements(r=0.897).The difference between the waist diameter of the occluder and the values measured by TTE and TEE in group A patients was small and not statistically significant(P＞0.05);The difference between the waist diameter of the occluder and the TEE measurement value in group B patients was significantly smaller than the difference with the TTE measurement value(P＜0.01).Conclusions For patients with atrial septal defect with strong residual echo and small amplitude of oscillation,TTE and TEE have considerable application value and can be used instead of TEE in case screening;For patients with atrial septal defect with thin residual echoes and large oscillation amplitude,further TEE examination is needed to help surgeons more accurately select suitable occluders.
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