ASD or PFO: State-of-the-art echocardiography says it all

Abstract

Atrial septal defect (ASD) and Patent Foramen Ovale (PFO) are two different entities from anatomic, pathophysiologic and haemodynamic perspective. We present a case of a 60 year old female with previous history of pulmonary valvuloplasty and recurrent cryptogenic stroke, that was referred for consideration of transcatheter ASD closure. However, the transoesophageal Echocardiogram (TOE) with state-of-the-art post processing techniques for real-time transcatheter device closure procedural guiding showed findings that were more suggestive of PFO rather than an ASD informing the correct diagnosis to the clinician and the patient. Because interatrial septum is a complex, dynamic and 3-dimensional structure, limitations exist in its evaluation using 2-dimensional TOE alone. The authors aim to discuss the utilisation of 3D TOE and its advanced post processing techniques which can provide incremental diagnostic and procedural information.

Keywords

• Atrial septal defect
• Patent foramen ovale
• Echocardiography