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Quantification of left to right shunts by echo Doppler cardiography in patients with ventricular septal defects
Insights
Color flow mapping accurately estimates ventricular septal defect (VSD) size and flow. This echocardiography technique provides a reliable method for calculating VSD area and QP/QS ratio, aiding in clinical assessment.
Area of Science:
- Cardiovascular Imaging
- Pediatric Cardiology
- Echocardiography
Background:
- Ventricular septal defects (VSDs) are common congenital heart abnormalities.
- Accurate quantification of VSD size and shunt flow is crucial for management.
- Echocardiography is a primary non-invasive tool for VSD assessment.
Purpose of the Study:
- To evaluate the utility of Echo Doppler cardiography and color flow mapping in assessing VSD.
- To estimate VSD area and flow using color flow mapping.
- To compare these echocardiographic estimates with established methods like angiography and radionuclide/oximetric techniques.
Main Methods:
- Thirty-one patients with VSD underwent Echo Doppler and color flow mapping.
- VSD area was estimated by measuring jet diameter via color flow mapping.
- VSD flow and aortic flow were calculated using cross-sectional area and velocity time integral; QP/QS ratio was derived and compared to other methods.
Main Results:
- Color flow mapping-derived VSD diameter showed high correlation with angiography (r = 0.88).
- Calculated QP/QS ratio demonstrated strong agreement with radionuclide or oximetric methods (r = 0.95).
- The study validates color flow mapping as an effective tool for VSD quantification.
Conclusions:
- Echo Doppler cardiography with color flow mapping provides accurate estimation of VSD size.
- This method reliably quantifies shunt flow (QP/QS ratio) in patients with VSD.
- Color flow mapping offers a valuable, non-invasive approach for VSD assessment and management.
Abstract:
Thirty-one patients with ventricular septal defect were evaluated with Echo Doppler cardiography and colour flow mapping. The ventricular septal defect area was estimated by measurement of the jet diameter by colour flow mapping. The ventricular septal defect flow was calculated as the product of the cross-sectional area of the ventricular septal defect and the velocity time integral of flow through the defect. In ten patients the diameter obtained by colour flow mapping was compared with the diameter obtained at angiography, r = 0.88 (SD = 0.14 cm). The aortic flow was calculated as the product of left ventricular outflow tract cross-sectional area and the corresponding velocity time integral. QP/QS ratio was estimated as (ventricular defect flow + aortic flow)/aortic flow and compared to estimates by a radionuclide or oximetric method. A correlation of r = 0.95 (SD = 0.23) was found.