[Two-dimensional echocardiographic assessment of systemic-pulmonary shunts in infants with cyanotic heart disease] (original) (raw)
To determine the feasibility and accuracy of noninvasive assessment of pulmonary artery and aortic arch anatomy, a prospective two-dimensional echocardiographic evaluation was performed in 20 consecutivecyanotic infants before cardiac catheterization and angiography. The echocardiographic assessment was correct with the following frequency: detection of left aortic arch in 13 of 13 infants, detection of right aortic arch in 7 of 7, identification of patent ductus arteriosus in 13 of 13 (one false positivefinding), identificationof a right pulmonary artery in 20 of 20, identification of a left pulmonary artery in 19 of 20, identification of the confluence of the right and left pulmonary arteries in 19 of 20 and iden-Infants with clinical and radiographic features of cyanotic congenital heart disease are often managed by cardiac catheterization and angiography, followed by the surgical creation of a systemic to pulmonary artery anastomosis. The purpose of the diagnostic procedures, in addition to the assessment of intracardiac anatomy, is to determine aortic arch and pulmonary artery anatomy to choose the optimal site for the surgical anastomosis. Since various portions of the aorta and pulmonary arteries can be visualized by twodimensional echocardiography, our study was undertaken to determine the accuracy of this technique in assessing aortic arch and pulmonary artery anatomy in a consecutive series of cyanotic infants studied before catheterization and angiography, tification of a main pulmonary artery in 14 of 16 (two false positive diagnoses by echocardiography). Echocardiographic estimates of arterial diameters were slightly smaller than those obtained by angiography. Mean vessel size (echoeardiographic/angiographjc diameter) was as follows: transverse aortic arch 8.6/10.6 mm, main pulmonary artery 5.7/6.3 mm, right pulmonary artery 4.114.2 mm and left pulmonary artery 4.2/3.9 mm, It is concluded that although two-dlmenslonal echocardiography tends to underestimate vessel size, the qualitative assessment is adequate for planning a systemic to pulmonary artery anastomosis in selected infants with cyanotic forms of congenital heart disease.
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