[Color-coded doppler echocardiography in atrial septal defects]

The magnitude of a left-to-right shunt in atrial septal defects was evaluated independently in catheterizations of the heart according to saturations and characteristics of the shunt stream in colour-flow Doppler echocardiography. The ratio of the pulmonary and systemic flow (Qp/Qs) assessed in 14 patients with atrial septal defects during catheterization correlated significantly with the maximal breadth (r = 0.8; p less than 0.001) and maximum area (r = 0.78; p less than 0.01) of the visualized shunted stream in transthoracic colour-flow Doppler echocardiography. Examination by means of transoesophageal colour-flow Doppler echocardiography in 8 patients revealed a correlation only with the maximal breadth of the shunted stream (r = 0.95; p less than 0.001). The magnitude of the maximum area of the shunted stream in transthoracic colour-flow Doppler echocardiography made it only possible to differentiate patients with a significant and not significant left-to-right shunt, i.e. Qp/Qs greater or smaller than 1.5:1. All patients with a shunt greater than 1.5:1 had a maximal area of the shunted stream greater than 10 sq.cm or 6 sq.cm/sq.m resp. Colour-flow Doppler echocardiography is a suitable method for the semiquantitative evaluation of the haemodynamic significance of atrial septal defects in adult patients.