Three-Dimensional Transesophageal Echocardiography With Agitated Saline Injection to Differentiate Between Atrial Septal Defects and Echo Drop-Out Artifacts

Abstract The diagnosis of multiple atrial septal defects is less challenging with 3-D transesophageal echocardiography. However, the common occurrence of echo drop-out (acoustic shadow) artifacts with 3-D echocardiography can make the differentiation between a second defect and an artifact challenging. Agitated saline injection with direct visualization using 3-D echocardiography can help resolve this by allowing visualization of the bubbles crossing from true defects.