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Echocardiographic visualization of ventricular septal defect in infants and assessment of hemodynamic status using a
Insights
Two-dimensional echocardiography (2-D echo) with peripheral contrast accurately visualizes ventricular septal defects (VSD) and estimates pressure ratios. M-mode echocardiography is less reliable for VSD imaging.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Diagnostic Imaging
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Accurate diagnosis and assessment of VSD are crucial for patient management.
- Traditional echocardiography methods have limitations in VSD visualization.
Purpose of the Study:
- To evaluate the efficacy of two-dimensional echocardiography (2-D echo) with peripheral venous contrast in diagnosing VSD.
- To assess the ability of this technique to determine the anatomic location and hemodynamic significance of VSDs.
- To compare the diagnostic value of M-mode and 2-D echo for VSD.
Main Methods:
- Twenty-seven pediatric patients (2 months to 2 years) with VSD were studied.
- Both M-mode and 2-D echocardiography were performed.
- A peripheral venous contrast technique was utilized in conjunction with 2-D echo.
Main Results:
- M-mode echocardiography proved unreliable for VSD imaging.
- 2-D echo successfully visualized VSDs in all patients, identifying location (membranous or supracristal).
- Contrast echocardiography revealed shunt direction and provided an estimate of the right-to-left ventricular peak pressure ratio.
Conclusions:
- 2-D echocardiography with peripheral contrast is a reliable method for confirming VSD location.
- This technique offers valuable hemodynamic information, including approximate ventricular pressure ratios.
- 2-D echo with contrast enhances VSD assessment compared to M-mode echocardiography.
Abstract:
Twenty-seven patients with ventricular septal defect (VSD), ages 2 months to 2 years, were evaluated by both M-mode and two-dimensional echocardiography (2-D echo) with the aid of a peripheral venous contrast technique. M-mode echocardiography was unreliable for imaging VSD. Using 2-D echo, defects in the interventricular septum were visualized in all patients examined; defects in the membranous portion (24 patients) were visualized by the subcostal frontal approach and defects in the supracristal portion (three patients) by the subcostal sagittal approach. The 2-D echo contrast study revealed negative contrast jets appearing through the defect in the right ventricle in 22 patients with a pulmonary-to-systemic blood flow ratio greater than 2.0, and positive contrast jets appearing through the defect in the left ventricle in 13 patients with a right-to-left ventricular peak pressure ratio greater than 0.71. We conclude that 2-D echo with peripheral contrast technique confirmed the anatomic location of VSD and indicated the approximate right-to-left ventricular peak pressure ratio, showing the contrast material shunting through the defect itself.