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Contrast echocardiography during cardiac catheterization in patients with congenital heart diseases
J L Andrade1, S M Leal, O Campos Filho
1Pediatric Cardiology Division, Escola Paulista de Medicina, São Paulo, Brasil.
Insights
Contrast echocardiography safely and effectively diagnoses congenital heart disease defects like shunts and valve regurgitation. This sensitive method enhances diagnostic accuracy during cardiac catheterization, reducing radiation exposure.
Area of Science:
- Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Contrast echocardiography in cardiac catheterization is underutilized, with limited case reports.
- Conventional contrast angiography carries risks of radiation and contrast agents.
Purpose of the Study:
- To assess the diagnostic capability of contrast echocardiography for cardiac shunts and valve regurgitation.
- To compare contrast echocardiography with conventional angiography in patients with congenital heart disease.
Main Methods:
- 37 patients with congenital heart disease underwent contrast echocardiography during cardiac catheterization.
- Injections of 5% dextrose in water were used to evaluate septal integrity and valve competence.
- Results were compared with conventional contrast angiography.
Main Results:
- Overall sensitivity was 93% and specificity was 78%.
- 100% sensitivity for atrial septal defects and mitral regurgitation.
- Higher sensitivity than conventional angiography for detecting mild valve regurgitation.
Conclusions:
- Contrast echocardiography is a sensitive and safe technique for diagnosing congenital heart disease.
- It can be used with conventional angiography to reduce radiographic contrast and radiation exposure.
- This method shows promise in improving diagnostic accuracy and patient safety.
Abstract:
Contrast echocardiography performed during cardiac catheterization has mostly been limited to a few published case reports. We studied 37 patients with congenital heart disease to assess the capability of the method to diagnose cardiac shunts and valve regurgitation. Injections of 5% dextrose in water through an angiographic catheter were made to evaluate septal integrity and valve competence compared with conventional contrast angiography. An overall sensitivity of 93% and specificity of 78% were found. In four cases of atrial septal defect and seven of mitral regurgitation, the sensitivity was 100%. It was slightly lower for eleven cases of ventricular septal defect (91%) and four of patent ductus arteriosus (75%). When assessing aortic, tricuspid and pulmonary valve competence, the method proved to be more sensitive than conventional angiography to detect mild regurgitation. Contrast echocardiography is a sensitive and safe technique that may be used in association with conventional angiography reducing the need for radiographic contrast and ionizing radiation time.