PMC6342334_01
Baseline transesophageal echocardiogram from case 1 demonstrates an intact interatrial septum by 2-dimensional (A, B), agitated saline (C), and color imaging (D).
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Baseline transesophageal echocardiogram (TEE) demonstrated an intact interatrial septum (Figure 1).
Intraprocedural transesophageal echocardiogram from case 1 after cryoballoon ablation demonstrates a large iatrogenic septal defect with inadequate rims (A, B) and large left-to-right shunt by color imaging (C, D).
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This demonstrated a tear of the atrial septum resulting in a large defect measuring up to 3 cm in diameter with bidirectional, continuous shunt, which was predominantly left to right (Figure 2).
PMC6342334_02
Follow-up transesophageal echocardiogram from case 2 (20 months after cryoballoon ablation) demonstrates a persistent iatrogenic atrial septal defect (A-C) and right ventricle enlargement (D).
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TEE revealed a large (1.2 cm) ASD (Figure 3) with significant left-to-right shunting (Qp:Qs 1:6). The right ventricular size was mildly enlarged compared to the previous studies and the systolic function was normal.