[Application of two dimensional echocardiography for the intracardiac manipulation: the evaluation of atrial septal movement before and after balloon atrial septostomy (author's transl)].

Two-dimensional echocardiography was applied to intracardiac catheter manipulation (especially balloon atrial septostomy: BAS) in 6 babies with complete transposition of the great arteries and 2 with total anomalous pulmonary venous drainage. Under the usual roentgenoscopic investigation, intracardiac catheter manipulation was observed by two-dimensional echocardiography directly representing the right atrium, left atrium, atrial septum, right ventricle, left ventricle and interventricular septum by the subcostal approach. Also, formation and movement of the atrial septum and intra-atrial shunt before and after BAS was evaluated by contrast echocardiography. 1. It was confirmed that the catheter tip was inserted into the left atrium from the right atrium. 2. It was clearly demonstrated that the balloon was expanding in the left atrium. 3. When the balloon was pulled out to the right atrium from the left atrium, the movement of the atrial septum and the balloon was observed. 4. The formation and movement of atrial septal defect by BAS was demonstrated and the shunt of this site was estimated by using contrast echocardiography. The relation between the catheter tip and the intracardiac structures can be judged more correctly by two-dimensional echocardiography than roentgenoscopic investigation. Also the structural and hemodynamic changes by BAS can be clearly estimated by the observation of the atrial septum by two-dimensional echography.