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Atrioventricular valve abnormalities in infancy: two-dimensional echocardiographic and angiocardiographic comparison
Insights
Two-dimensional echocardiography and biplane angiocardiography show good agreement for diagnosing congenital atrioventricular (AV) valve abnormalities in infants. Echocardiography excels at visualizing chordal attachments, while angiocardiography better demonstrates flow patterns and orifice size.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Congenital Heart Disease
Background:
- Congenital atrioventricular (AV) valve abnormalities are a significant cause of pediatric heart disease.
- Accurate diagnosis is crucial for effective management and surgical planning.
- Comparing diagnostic modalities is essential for optimizing patient care.
Purpose of the Study:
- To compare the diagnostic accuracy of two-dimensional echocardiography and biplane angiocardiography in infants with congenital AV valve abnormalities.
- To evaluate the strengths and limitations of each imaging technique for specific cardiac structures and functions.
Main Methods:
- Retrospective analysis of data from 47 infants with congenital AV valve abnormalities.
- Comparison of findings from two-dimensional echocardiography and biplane angiocardiography.
- Assessment of agreement between the two imaging modalities for valve presence, annular size, septal defects, and valve morphology.
Main Results:
- High agreement between echocardiography and angiocardiography regarding the number of AV valves.
- Echocardiography underestimated annular diameter in hypoplastic cases compared to angiocardiography.
- Echocardiography visualized chordal attachments better, while angiocardiography better demonstrated flow patterns and orifice size.
- Subcostal echocardiographic and cranially angulated angiographic views provided optimal imaging for AV valve assessment.
Conclusions:
- Both echocardiography and biplane angiocardiography are valuable tools for evaluating congenital AV valve abnormalities in infants.
- Each modality offers complementary information, with echocardiography excelling in structural detail and angiocardiography in functional assessment.
- Combined use of these techniques, particularly specific views, enhances diagnostic precision for complex congenital heart defects.
Abstract:
The results of two-dimensional echocardiography and biplane angiocardiography from 47 infants with congenital atrioventricular (AV) valve abnormalities were compared. Eleven patients had atresia of the right AV valve, 10 had atresia of the left AV valve, 4 had hypoplasia of the right AV valve and 5 had hypoplasia of the left AV valve. Twelve patients had endocardial cushion defect, three had single ventricle and two had straddling of the left AV valve. There was agreement between the two techniques as to the number of AV valves present in each patient. The echocardiographic estimate of valve anular diameter was below normal in seven of the eight patients thought to have a hypoplastic anulus by angiocardiography. In 10 of the 12 patients with endocardial cushion defect, there was agreement between the two techniques as to the presence or absence of atrial and ventricular septal defect. The chordal attachments of straddling valves were better visualized by echocardiography; flow patterns and effective orifice size were better demonstrated by angiocardiography. The subcostal four chamber echocardiographic views and cranially angulated oblique angiocardiographic views were comparable and provided the best images for determination of the size and number of AV valves and their relation to the atrial and ventricular septa.