Multiplane transesophageal echocardiography in the diagnosis of sinus venosus atrial septal defect in adults

Atrial septal defect (ASD) is one of the most common congenital cardiac malformations seen in adults. The presence and approximate size of an ASD can be assessed accurately in well over 90% of cases by transthoracic echocardiography (TTE) with a subxiphoid four-chamber view. Sinus venosus atrial septal defect (SVASD) is relatively rare and is found in the superoposterior interatrial septum near its junction with the superior vena cava. An SVASD may be misdiagnosed with TTE due to its posterior location. This report describes the difficulty in diagnosis of SVASD using coventional TTE with color flow mapping in three adult patients, but its comparitive ease using multiplane transesophageal echocardiography (MTEE). MTEE with color flow mapping offers the advantage of anatomic proximity and a perpendicular view of the interatrial septum and thus provides a good non-invasive tool in the diagnosis and understanding of the hemodynamics of SVASD.