Document Detail

Detection of left-to-right shunt in atrial septal defect by negative contrast echocardiography: a comparison of transthoracic and transesophageal approach.
MedLine Citation:
PMID:  8213449     Owner:  NLM     Status:  MEDLINE    
The occurrence of a right atrial negative contrast effect as an indicator of left-to-right shunt was studied in 101 patients with atrial septal defect by peripheral venous contrast injection during transthoracic and transesophageal echocardiography. Confirmation of the diagnosis was provided by cardiac catheterization or by autopsy in 72 (72%) patients. The defect could be visualized directly in 57 (57%) patients during the transthoracic and in 93 (93%) during the transesophageal examination (p < 0.001). A negative right atrial echo contrast effect was observed in 53 of 92 (58%) patients from the transthoracic and in 86 of 92 (93%) patients from the transesophageal approach (p < 0.001). Among these were seven (7%) patients with an aneurysmal interatrial septum but no directly visible defect during conventional transesophageal imaging. Appearance of contrast in the left atrium indicating right-to-left shunting was seen in 70 of 92 (76%) patients from the transthoracic and in 91 of 92 (99%) patients from the transesophageal approach (p < 0.001). Contrast injection during transesophageal imaging also helped identify additional malformations in 12 (12%) patients. Thus transesophageal echocardiography with echo contrast injection is a very reliable diagnostic method in patients with suspected atrial septal defect.
S Konstantinides; W Kasper; A Geibel; T Hofmann; W Köster; H Just
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  126     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-01     Completed Date:  1993-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  909-17     Citation Subset:  AIM; IM    
Innere Medizin III, Universitätsklinik Freiburg, Germany.
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MeSH Terms
Confidence Intervals
Contrast Media
Echocardiography / instrumentation,  methods*,  statistics & numerical data
Echocardiography, Transesophageal / instrumentation,  methods*,  statistics & numerical data
Evaluation Studies as Topic
Gelatin / analogs & derivatives,  diagnostic use
Heart Septal Defects, Atrial / epidemiology,  ultrasonography*
Heart Septum / ultrasonography
Linear Models
Middle Aged
Polysaccharides / diagnostic use
Prospective Studies
Reg. No./Substance:
0/Contrast Media; 0/Polysaccharides; 9000-70-8/Gelatin; 9005-91-8/oxypolygelatine; 90881-70-2/SHU 454

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