Echocardiographic detection of intracardiac right-to-left shunts following peripheral vein injections
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This study shows peripheral contrast echocardiography effectively detects and locates right-to-left intracardiac shunts. This safe and sensitive method aids in evaluating systemic desaturation in children.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Echocardiography
Background:
- Intracardiac right-to-left shunts can cause systemic desaturation.
- Accurate detection and localization are crucial for patient management.
- Existing diagnostic methods may have limitations.
Purpose of the Study:
- To describe and evaluate a contrast echocardiographic technique.
- To assess its utility in detecting and localizing intracardiac right-to-left shunts.
- To determine its safety and sensitivity.
Main Methods:
- A contrast echocardiographic technique using peripheral vein injections was developed.
- Fifty children underwent both cardiac catheterization and the contrast echocardiographic study.
- Shunt characteristics were confirmed via catheterization (oximetry, indicator dilution, angiography).
Main Results:
- Right-to-left shunts were confirmed in 27 out of 50 patients via catheterization.
- The contrast echocardiographic technique correctly identified the presence and level of shunting in all 27 patients.
- The technique accurately detected and localized shunts from peripheral venous injections.
Conclusions:
- Peripheral contrast echocardiography is a safe and sensitive method for detecting and localizing intracardiac right-to-left shunts.
- This technique is valuable for evaluating systemic desaturation in pediatric patients.
- It offers a reliable diagnostic tool for both ambulatory and postoperative settings.
Abstract:
A contrast echocardiographic technique using peripheral vein injections for the detection and localization of intracardiac right-to-left shunting is described. Fifty children underwent cardiac catheterization and peripheral contrast echocardiographic studies. The site, degree, and direction of shunting were established at catheterization by oximetry, indicator dilution analysis and/or angiography. Peripheral vein injections were performed from the right antecubital vein or the right saphenous vein. Right-to-left shunts were documented at catheterization in 27/50 patients; contrast echocardiographic studies indicated the presence and level of shunting in all 27 patients. The contrast echocardiographic technique using peripheral vein injections detects and localizes right-to-left intracardiac shunting. It is a safe and sensitive method to evaluate systemic desaturation in ambulatory and postoperative patients.