{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:16:50Z","timestamp":1787840210681,"version":"build-2784847793"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>Cyanosis due to right to left shunt across an atrial septal defect (ASD) brings up lots of questions in an inquisitive mind! Systemic desaturation at rest or during exercise can limit physical ability and impair the quality of life of patients with congenital heart defect (CHD). Traditionally, ASD is taught as an acyanotic CHD, but we encountered a child with a different clinical presentation. Understanding the mechanism of early onset systemic desaturation in the presence of an ASD is vital for surgical planning and decision-making. A comprehensive TEE examination always compliments clinical and haemodynamic data for an aetiology based patient management. This brief clinical communication attempts to discuss the role of perioperative TEE examinations in a case of ASD with central cyanosis.<\/jats:p>","DOI":"10.4103\/aca.aca_199_17","type":"journal-article","created":{"date-parts":[[2018,7,25]],"date-time":"2018-07-25T08:39:12Z","timestamp":1532507952000},"page":"287-289","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Early Onset of Cyanosis in a Patient with Atrial Septal Defect: Transesophageal Echocardiography Reveals the Underlying Mechanism"],"prefix":"10.4103","volume":"21","author":[{"given":"Rohan","family":"Magoon","sequence":"first","affiliation":[{"name":"Department of Cardiac Anaesthesia, CN Centre, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, CN Centre, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameya","family":"Karanjkar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, CN Centre, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ummed","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, CN Centre, AIIMS, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250602","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/0002-8703(61)90608-1","article-title":"Atrial septal defect and the mechanism of shunt","volume":"61","author":"Rowe","year":"1961","journal-title":"Am Heart J"},{"key":"R2-20250602","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1161\/01.CIR.37.4.476","article-title":"Atrial pressure-flow dynamics in atrial septal defects (secundum type)","volume":"37","author":"Levin","year":"1968","journal-title":"Circulation"},{"key":"R3-20250602","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1136\/hrt.35.9.894","article-title":"Quantitative aspects of right-to-left shunting in uncomplicated atrial septal defects","volume":"35","author":"Rasmussen","year":"1973","journal-title":"Br Heart J"},{"key":"R4-20250602","first-page":"2146","article-title":"Acase of congenital tricuspid regurgitation associated with atrial septal defect and peripheral pulmonary stenosis","volume":"44","author":"Tanji","year":"1996","journal-title":"Nihon Kyobu Geka Gakkai Zasshi"},{"key":"R5-20250602","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/0002-8703(94)90666-1","article-title":"Right-to-left shunt across atrial septal defect related to tricuspid regurgitation: Assessment by transesophageal doppler echocardiography","volume":"127","author":"Kai","year":"1994","journal-title":"Am Heart J"},{"key":"R6-20250602","first-page":"565","article-title":"Functional tricuspid valve regurgitation in adults with congenital heart disease: An emerging problem","volume":"20","author":"Giamberti","year":"2011","journal-title":"J Heart Valve Dis"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00660469-201821030-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:16:48Z","timestamp":1787836608000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00660469-201821030-00012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_199_17","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}