ABSTRACT
Three patients with total anomalous pulmonary venous drainage (TAPVD) were studied by real-time cross-sectional colour-flow Doppler echocardiography. Serial suprasternal, parasternal and subcostal scans were obtained. In all cases surgical or angiocardiographic confirmation was available. Two patients had supracardiac drainage (to the left vertical vein or to the right superior vena cava) and one patient had infracardiac drainage. An abnormal forward flow in the left innominate vein and vertical vein was visualized in those patients with supracardiac TAPVD. Abnormal venous flow was also imaged in one patient with mixed drainage. In the patient with infradiaphragmatic TAPVD characteristic flow signals were identified in the inferior vena cava (retrograde flow) and in the descending aorta and anomalous pulmonary venous channel (forward flow). In all patients the patterns of pulmonary venous flow allowed us to distinguish TAPVD from contiguous structures and to validate two-dimensional cross-sectional imaging.
Subject(s)
Echocardiography/methods , Heart Defects, Congenital/diagnosis , Pulmonary Veins/abnormalities , Brachiocephalic Veins/abnormalities , Cardiac Catheterization , Color , Heart Atria/abnormalities , Hemodynamics , Humans , Infant , Infant, Newborn , Pulmonary Circulation , Vena Cava, Superior/abnormalitiesABSTRACT
In order to assess the presence and severity of left-to-right shunt at ductal level, eleven patients with proven ductus arteriosus (PDA), ages 1 day to 16 years, were examined by real-time two-dimensional Doppler echocardiography. Eighteen subjects with no signs of cardiovascular disease were selected as normal controls. Normal pulmonary flow pattern was clearly visualized in the healthy subjects examined. The jet stream through the ductus was well imaged in the main pulmonary artery in patients with PDA and disappeared in two infants after pharmacologic manipulation with indomethacin. The colour-coded shunt area was related to the left-to-right shunt calculated at cardiac catheterization. Moreover, the combined use of colour-flow Doppler and continuous-wave Doppler yielded a reliable noninvasive assessment of pulmonary artery pressure.
