Single-Plane Balloon Sizing of Atrial Septal Defects with Intracardiac Echocardiography: An Advantageous Alternative to Fluoroscopy

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We sought to evaluate intracardiac echocardiography (ICE) in comparison with transesophageal echocardiography and fluoroscopy for sizing of atrial septal defects (ASDs).


In 43 patients (mean age 40 ± 15 years) with ASD, the native defect size was measured by transesophageal echocardiography and ICE. On subsequent balloon sizing, the stretched balloon diameter was measured by both fluoroscopy in two perpendicular planes and by ICE in just a single standard cut plane.


All ASDs were successfully closed with Amplatzer occluders (AGA Medical Corp., Plymouth, Minn). Conventional fluoroscopy-based balloon sizing revealed diameters of 17.5 ± 5.4 mm, transesophageal echocardiography diameters of 11.8 ± 3.3 mm (P < .001), and ICE measurement of native ASD diameters of 13.5 ± 4.1 mm (P < .001). Single-plane ICE balloon sizing revealed diameters of 16.9 ± 5.2 mm and corresponded well with fluoroscopy:R= 0.98,P< .001.


As a sizing tool, ICE is an accurate alternative to fluoroscopy and helps to decrease radiation exposure.

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