Atrial Septal Defects and Atrial Anomalies

Transesophageal echocardiography (TEE) allows for a comprehensive assessment of atrial chamber and atrial septal anatomy. Due to the posterior position of the TEE probe in the esophagus relative to the heart, and therefore its proximity to the atria, high-resolution imaging of venous structures as they drain into the heart, definition of atrial chamber morphology, and characterization of the atrial septum represent particular strengths of this modality. Combined with color flow mapping and spectral Doppler interrogation, TEE is able to define communications at the atrial level, anatomic variants of the atria, and pathologic conditions that may affect these structures. This chapter focuses on the role of TEE in the characterization of atrial septal defects and atrial anomalies, including conditions such as juxtaposition of the atrial appendages and cor triatriatum.