A Comparative Study of Computed Tomography and Ultrasound Imaging on Device Size during Percutaneous Atrial Septal Defect Closure

Atrial septal defect (ASD) is one of the most commonly found congenital heart diseases, and percutaneous obstruction is currently being applied as the primary treatment in place of surgery. For successful closure, it is very important to determine the exact anatomical structure of the pre-procedure defect and to determine the appropriate closure device for the maximum size of the defect. Therefore, this study attempted to compare the size of the device applied to ASD obstruction in actual patients with ASD size measured through transesophageal echocardiography, intracardiac echocardiography, and cardiac CT scans and to evaluate the usefulness of cardiac CT scans. In this study, 62 adults over the age of 20 who underwent percutaneous obstruction of an ASD were studied retrospectively, and transesophageal echocardiography and intracardiac echocardiography measured the longest major axis of ASD based on images recorded in the medical image storage transmission system. In cardiac CT, the major axis was measured in the cardiac systolic phase, where the size of ASD was maximized. Only 36-45% of the electrocardiogram R-R peak interval was classified and examined by cardiac systolic phase. As a result of the experiment, the average size of the ASD closure device was 20.41 mm, and the average length of the ASD major axis measured by transesophageal echocardiography (TEE), intracardiac echocardiography (ICE) and cardiac CT was 16.90 mm, 17.11 mm, and 19.04 mm, respectively. The absolute values of the variation index were 3.91 ± 0.33 mm, 3.35 ± 0.22 mm, and 2.22 ± 0.19 mm, respectively, and all statistical analysis results showed significant differences.(P<0.05) This study, which compared the device size applied to the patient's ASD obstruction with the patient's ASD size measured by TEE, ICE, and cardiac CT, has the most similar results of cardiac CT, and it is thought that if images are acquired in the cardiac systolic phase, it will be possible to acquire high-value images in the diagnosis of ASD along with unnecessary dose reduction of the patient.