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[Quantitative Doppler echocardiography diagnosis of congenital aortic and pulmonary artery stenoses]
H J Häusler1, P Schneider, K F Lindenau
1Kardiologischen Abteilung, Bereiches Medizin der Karl-Marx-Universität Leipzig.
Insights
Doppler echocardiography accurately assesses congenital aortic and pulmonary stenosis severity in children. This reliable method guides surgical decisions and reduces the need for invasive cardiac catheterization.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
Context:
- Congenital heart defects, specifically aortic and pulmonary stenosis, require accurate severity assessment in pediatric patients.
- Traditional methods for pressure gradient determination can be invasive.
Purpose:
- To evaluate the diagnostic value of continuous-wave (cw) Doppler echocardiography in assessing the severity of congenital aortic and pulmonary stenosis in children and adolescents.
- To compare cw-Doppler derived pressure gradients with those obtained from direct intracardiac pressure measurements.
Summary:
- A 3-year study involved 217 children with aortic stenosis and 98 with pulmonary stenosis undergoing echocardiography.
- Pressure gradients measured by cw-Doppler showed excellent agreement with direct measurements in both aortic (r=0.939) and pulmonary (r=0.969) stenosis.
- Doppler echocardiography proved to be a reliable method for determining pressure gradients.
Impact:
- Enables accurate selection of pediatric patients with aortic stenosis for surgical intervention.
- Facilitates surgical treatment without the need for preoperative cardiac catheterization in select cases.
- Provides a safe basis for indicating balloon valvuloplasty in pediatric patients with valvular pulmonary stenosis using 2D and Doppler echocardiography.
Abstract:
The aim of the present study was to check the value of cw-Doppler echocardiography for the assessment of severity of congenital aortic and pulmonary stenoses in children and adolescents. Over a period of 3 years 217 children and adolescents with aortic and 98 with pulmonary stenosis, resp., underwent echocardiography. In 21 patients with aortic and in 23 with pulmonary stenosis pressure gradients were determined by cw-Doppler as well as intracardiac pressure measurement. The comparison showed excellent accordance between both sorts of data for aortic stenoses (r = 0.939) and pulmonary stenosis (r = 0.969). These results show that Doppler echocardiography is a reliable diagnostic method for the determination of pressure gradients. Thus, it allows correct selection of children and adolescents with aortic stenosis for surgery. So far, 12 patients have been operated on without preoperative cardiac catheterization. Indication for balloon valvuloplasty in patients with valvular pulmonary stenosis can be based safely on 2 D- and Doppler echocardiography.