RESUMO
120 children (58 boys, 62 girls) aged 2 days-12 years (mean 3.5 +/- 3 years) with pulmonary or aortic valve stenosis underwent the study. Diagnosis was proved by a cardiac catheterization and angiography. There were determinated maximal flow velocities and pressure gradients through stenosed valve using the doppler ultrasound method. Values were compared with those obtained from cardiac catheterization. There were no statistically significant differences between these two methods. Increased blood flow velocities through the aortic or pulmonary valves were stated in the examined group comparing with healthy individuals. Obtained results prove Doppler method usefulness in diagnosis of aortic and pulmonary valve stenosis. In pulmonary valvular and subvalvular stenosis the Doppler method is useful for estimation of outflow tract obstruction while in a extreme case a results can be incompetent.
Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico por imagem , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , UltrassonografiaRESUMO
Coarctation may be suspected on two-dimensional echocardiography upon notation of an apparent narrowing of the lumen of the aorta, but sometimes the picture is not clear. The purpose of this study was the assessment the detection of coarctation in children with associated defects and if pressure gradient through the obstruction could be accurately estimated from Doppler. Methods. The study included 45 children (38 with coarctation of aorta and 7 with recoarctation) between the ages of 3 days to 14 years. The diagnosis was confirmed by cardiac catheterization and angiocardiography. Doppler echocardiographic studies were performed in all patients before surgery and in 40 patients after surgery. Doppler examination were performed with the use of continuous-wave flow meter Kardiodop KD-84 (Sonopan) with estimation of maximal velocity with histograph Doma HSD-83 (Domar) or with the use of Ultramark 4 Ultrasound System (ATL). The pressure gradient across the stenosis was calculated by using modified Bernoulli equation, and was defined as the subtraction of the square of the maximal velocity x 4 the descending and ascending aorta. Arm and tight cuff sphygmomanometer measurements were performed at the rest. Pressure drop in the descending aorta was measured by sphygmomanometry in 19 children and by catheterization in 10 children. The results were compared with Doppler calculated pressure gradients. Results. The maximal velocity in descending aorta increased on the average to 3.6 +/- 1.2 m/s was recorded in 43 children. With increasing severity velocities were higher, and with severe obstruction a pressure drop across the coarctation may persist throughout diastole and continuous forward flow was seen.(ABSTRACT TRUNCATED AT 250 WORDS)