Real‐Time Three‐Dimensional Echocardiography Is Useful in the Evaluation of Patients with Atrioventricular Septal Defects

Abstract

We sought to determine whether three-dimensional echocardiography (3DE) is useful in the evaluation of patients with atrioventricular septal defect (AVSD). Recent advances in 3DE have enhanced its practicality. We assessed whether 3DE provided new information compared to 2DE among patients with AVSD. We retrospectively reviewed 52 3DE datasets from 51 patients (median age: 4.6 years, range 0-30 years; median BSA: 0.6 m2, range 0.2-1.9 m2) with any type of AVSD during a 1-year period. 3DE findings were compared to 2DE and surgical reports. For each study, AVSD was classified by 2DE as one of the following: unrepaired balanced defect, repaired balanced defect with residual lesions, repaired balanced defect without residual lesions, or unbalanced defect. 3DE was graded as (1) Additive: 3DE resulted in a new finding or changed diagnosis; (2) Useful: While useful, 3DE did not result in new findings or changed diagnosis; or (3) Not useful. 3DE on unrepaired balanced AVSD and repaired AVSD with residual lesions was more often additive/useful (33/36; 92%) than on repaired AVSD without residual lesions or unbalanced AVSD (9/16 (56%), P=0.009). 3DE was additive or useful in all three patients with unbalanced AVSD being considered for biventricular repair. Useful information obtained by 3DE included: precise characterization of mitral regurgitation and cleft leaflet, substrate for subaortic stenosis, valve anatomy, and presence and location of additional septal defects. 3DE provides useful and additive information in unrepaired balanced AVSD, repaired AVSD with residual lesions, and unbalanced AVSD under consideration for biventricular repair.