ABSTRACT
La comunicación interauricular (CIA) es uno de los defectos congénitos que se diagnostica con más frecuencia en el adulto. La ecocardiografía Doppler (ED) es el método de primera elección para su diagnóstico y seguimiento. La resonancia magnética cardiovascular (RMC), con sus múltiples aplicaciones, puede ser una excelente alternativa para su estudio. Para analizar la utilidad de la RMC en esta patología, se estudiaron 30 pacientes con CIA y se compararon los resultados con la ED. Veintitrés pacientes tenían CIA de tipo ostium secundum, 6 de tipo seno venoso y 1 de tipo ostium primum. Se observó buena correlación entre la RMC y la ED en los flujos aórticos (r = 0,67, p < 0,007), pulmonar (r = 0,62, p < 0,01) y Qp/Qs (r = 0,56, p < 0,003). Únicamente con la RMC se pudo visualizar el defecto en visión frontal y cuantificar el flujo que lo atraviesa. La planimetría directa de la CIA se correlacionó adecuadamente con el flujo cuantitativo pulmonar y a través del defecto interauricular, corroborándose los resultados obtenidos por estas dos técnicas en el estudio de RMC. Se concluye que la RMC presenta buena correlación con la ED y que es una alternativa válida para el estudio de la CIA. La visualización frontal del defecto con la cuantificación de su flujo es una ventaja de la RMC sobre la ED.
Atrial septal defect (ASD) is one of the most frequent congenital defects diagnosed in adult patients. Doppler echocardiography (DE) is the method of choice for its diagnosis and follow-up. Cardiovascular magnetic resonance (CMR), with its multiple applications, may be an excellent alternative for the assessment of this disorder. To analyze the usefulness of CMR in ASD, we evaluated 30 patients with ASD and compared the results with those of DE. Twenty three patients had a ostium secundum type of ASD, 6 had a sinus venosus ASD and 1 had an ostium primum ASD. There was good correlation between CMR andDE in the aortic flows (r=0.67, p<0.007), pulmonary flows (r=0.62, p<0.01) and Qp/Qs (r=0.56, p<0.003). The frontal view of the ASD could only be assessed with CMR, which also allowed to quantify the flow through the defect. Direct planimetry of the ASD correlated adequately with quantitative pulmonary flow and the flow through the interatrial defect; additionally, the results obtained with both techniques were confirmed by CMR. We conclude that CMR correlates well with DE and is a valid alternative for the assessment of ASD. The frontal visualization of the defect and its flow quantification represent an advantage of CMR over DE.
Subject(s)
Humans , Heart Septal Defects, Atrial/diagnosis , Heart Septal Defects, Atrial , Echocardiography, Doppler , Magnetic Resonance Imaging/methods , Heart Defects, Congenital/diagnosis , Heart Defects, CongenitalABSTRACT
The association of tetralogy of Fallot with atrial isomerism has been rarely reported. Eight cases (five with left isomerism and three with right isomerism) are known. This paper reports two other cases of tetralogy of Fallot with left atrial isomerism. The syndrome's defects were disguised and without clinical expression because of the presence of the right ventricular outlet obstruction of tetralogy of Fallot. These diagnostic elements, not recognized in one of the patients previous to surgical correction of tetralogy of Fallot, were present: junctional rhythm, bronchial isomerism, partial anomalous pulmonary vein connection, agenesy of inferior vena cava and abdominal heterotaxy; their identification previous to surgical correction of tetralogy of Fallot, is necessary for an adequate surgical management.