ABSTRACT
In order to evaluate the usefulness of Doppler echocardiography (continuous wave) in the assessment of obstructive cardiopathies, we studied the patients with pulmonary or aortic valvar stenosis examined from January 1988 to August 1989 in our Hospital. Doppler echocardiographic studies were performed on 35 patients, 19 with pulmonary valvar stenosis and 16 children with aortic valvar stenosis. Pulmonary flow was recorded from the left parasternal position (3-4 intercostal space) and aortic flow from the right parasternal position (3-4 intercostal space), apical and suprasternal notch window. We calculate the pressure gradient by the modified Bernoulli equation. The mean right Doppler gradient was 62 +/- 14 mmHg (ranged from 45 to 95) and the mean left Doppler gradient 64 +/- 29 mmHg (ranged from 30 to 150). The accuracy of Continuous Wave Doppler Echocardiography technique in our patients was verified by linear regression analysis of doppler-calculated and catheterization-measured gradients when the procedures were performed sumultaneously or within 48 hours. The statistical analysis included 19 children with pulmonary valvar stenosis and 16 with aortic valvar stenosis. This study confirms that Doppler echocardiography technique is an accurate and simple method to assess the cardiopathies with outflow obstruction. We believe that catheterization-measured gradients can be replaced by doppler-calculated ones, since there is an excellent correlation between them when they are performed simultaneously.
Subject(s)
Aortic Valve Stenosis/diagnostic imaging , Echocardiography, Doppler , Pulmonary Valve Stenosis/diagnostic imaging , Adolescent , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
We present seven cases of congenital absence of pulmonary valve observed during a 15 years period. There are five females and two males, aged from one day to six years. Three patients with a birth weight under 1.500 g died in the first 24 hours. All the patients had a systolic diastolic murmur and a single second sound. Two dimensional echocardiography was the procedure that allowed a definite diagnosis. In the valvular ring area a fixed ecogenic image was observed during the cardiac cycle. The pulmonary trunk and branches were dilated and the valvular ring was normal or small. In four patients the study was completed with catheterism and angiocardiography. Two were operated upon, with closing of the ventricular septal defect, aortic hemograft in pulmonary situation and reduction of pulmonary artery branches size.
Subject(s)
Pulmonary Valve/abnormalities , Aortic Valve/transplantation , Cardiac Catheterization , Echocardiography , Female , Heart Valve Prosthesis , Humans , Infant , Infant, Newborn , Male , Pulmonary Valve/surgery , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/etiologyABSTRACT
The diagnostic value of esophagograms was studied in 67 patients with aortic arch abnormalities and tracheoesophageal compression. This group of patients included the following malformations: double aortic arch (11), retroesophageal subclavia (48), retroesophageal aorta (5), cervical arch with retroesophageal component (2) and anomalous left pulmonary artery (sling) (1). Three types of esophageal indentation were observed in the esophagogram: anterior, posterior and bilateral. Anterior indentation was caused by the left pulmonary artery, and posterior indentation, when isolated, was caused by the retroesophageal subclavia. Posterior indentation associated with bilateral indentation was present in cases of double aortic arch. The upper lateral indentation was always caused by the predominant arch. We conclude that esophagogram is an easy and valid method for the diagnosis of this type of pathology.
