Atrial septal defect cardiac catheterization

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]

Overview

Cardiac catheterization is a lesser utilized imaging modality. Many of the observations/visualizations made on a cardiac catheterization can be visualized confidently in non-invasive measures such as echocardiography. When echocardiography falls short, cardiac catheterization can be an effective tool in detection of the atrial septal defect. It is especially effective in determining the coronary anatomy of the atrial septal defect and surrounding structures.

Cardiac Catheterization

Cardiac catheterization serves as a diagnostic modality capable of assisting with diagnostic and treatment elements related to atrial septal defect care. It is lesser utilized than the gold standard, echocardiography, as non-invasive methods often serve to diagnose atrial septal defects with greater confidence.

Advantages

Effective tool for visualizing device closure and surgical procedure success.
Effectively evaluates:

Defect size
Pulmonary venous return
Associated valvular diseases
Pulmonary vascular resistance
Pulmonary artery hypertension

Can be utilized to assess coronary artery disease in at-risk patients due to age or family history.

2008 ACC / AHA Guidelines – Evaluation of the Unoperated Patient – Atrial Septal Defect (DO NOT EDIT)[1]

2008 ACC / AHA Guidelines – Evaluation of the Unoperated Patient – Atrial Septal Defect (DO NOT EDIT)^[1]

Class I
“1. ASD should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of RV volume overload and any associated anomalies. (Level of Evidence: C) ”
“2. Patients with unexplained RV volume overload should be referred to an ACHD center for further diagnostic studies to rule out obscure ASD, partial anomalous venous connection, or coronary sinoseptal defect. (Level of Evidence: A)”

Class III (Harm)
“1. In younger patients with uncomplicated ASD for whom imaging results are adequate, diagnostic cardiac catheterization is not indicated. (Level of Evidence: B)”

Class IIa
“1. Cardiac catheterization can be useful to rule out concomitant coronary artery disease in patients at risk because of age or other factors. (Level of Evidence: B) ”

References

↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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[pmid19038677-1] Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). “ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons”. J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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