TEE image acquisition
Both 2D-TEE and 3D-TEE images were acquired by the GE Vivid E9 color Doppler platform (GE Vingmed Ultrasound AS, Horten, Norway) equipped with a 6VT transesophageal phased array probe during the procedure with the patients under anesthesia. Obtain two dimensional gray images of ASDs in 5 cardiac cycles when 2D-TEE clearly showed the cardiac defects in different planes from four-chamber (0), short axis (45°), and bicaval (110°) view at mid-esophageal level. After which the 4D zoom function was applied to get the 3D-TEE images. Once the 4D mode was entered, 5 continuous root cycles volume images of the ASD were stored under single-beat mode. The desired 3D-TEE images should have completely dark blood pool and bright myocardial tissue with minimized noise in the blood pool and at the periphery of the data set. All the 2D-TEE and 3D-TEE images were exported to the EchoPAC workstation (GE Healthcare, WI) anonymously and the 3D-TEE images were converted to standard digital imaging and communications in medicine (DICOM) format (Fig. 1A ).