Views: 1,421 | Downloads:
28
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Limitation of Transthoracic Echocardiography in the Diagnosis of Congenital Heart Diseases
Soongswang J 
,
Nana A ,
Laohaprasitipom D ,
Durongpisitkul K ,
Kangkagate C ,
Rochanasiri W ,
Kovitcharoentrakul T
,
Nana A ,
Laohaprasitipom D ,
Durongpisitkul K ,
Kangkagate C ,
Rochanasiri W ,
Kovitcharoentrakul T Nowadays, it has been widely accepted that echocardiography is the most efficient, non
invasive diagnostic tool to diagnose congenital heart diseases. However, cardiac catheterization
remains the gold standard to diagnose and obtain hemodynamic data prior to cardiovascular
surgery. In order to find out the accuracy of transthoracic echocardiography in relation to the
anatomical diagnosis of congenital heart diseases, 175 consecutive patients who underwent
diagnostic cardiac catheterization during January 1999 to December 1999 were reviewed. All of them
had complete echocardiographic studies prior to the procedure. The male to female ratio was
1.06:1. The median age at the time of echocardiography was 3.36 (0.0 1-28.8) years old. The
indications of the cardiac catheterization were to demonstrate cardiovascular anatomy 64 per
cent, to obtain pulmonary artery pressure and pulmonary vascular resistance 13.7 per cent, and
to get both information 22.3 per cent. Tetralogy of Fallot (23.4%) was the most frequent cardiac
malformation, followed by complex congenital heart diseases (22.3%), simple left to right shunt
(12%), pulmonary atresia with ventricular septal defect (8.6%), tricuspid atresia (5.7%), simple
d-transposition of great arteries (4%), etc. From cardiac catheterization; 49 cases (28%) revealed
additional data which were surgically important, 3 cases (1.7%) resulted
in
different diagnoses.
and 3 cases (1.7%) revealed additional information which was not surgically important. Inadequate
imaging technique (36 cases, 65.5%) and limitation of technique (19 cases, 34.5%) were the
reasons for missing anatomical findings of transthoracic echocardiography. Age at the time of
echocardiography was not a significant factor affecting the accuracy. Persistent left superior vena
cava, multiple aorto-pulmonary collateral arteries, pulmonary artery anatomy, and coronary artery
anatomy were the most frequent cardiac lesions misdiagnosed by transthoracic echocardiography
that were somewhat surgically important. The incorrect echocardiographic diagnoses were
aorta-
pulmonary window, patent ductus arteriosus, and vascular ring. Thorough and extensive echocar-
diographic scanning coupled with cooperative or adequately sedated patients by an experienced
*Division of Cardiology, Department of Pediatrics,
** Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok I 0700. Thailand.
Sl12
invasive diagnostic tool to diagnose congenital heart diseases. However, cardiac catheterization
remains the gold standard to diagnose and obtain hemodynamic data prior to cardiovascular
surgery. In order to find out the accuracy of transthoracic echocardiography in relation to the
anatomical diagnosis of congenital heart diseases, 175 consecutive patients who underwent
diagnostic cardiac catheterization during January 1999 to December 1999 were reviewed. All of them
had complete echocardiographic studies prior to the procedure. The male to female ratio was
1.06:1. The median age at the time of echocardiography was 3.36 (0.0 1-28.8) years old. The
indications of the cardiac catheterization were to demonstrate cardiovascular anatomy 64 per
cent, to obtain pulmonary artery pressure and pulmonary vascular resistance 13.7 per cent, and
to get both information 22.3 per cent. Tetralogy of Fallot (23.4%) was the most frequent cardiac
malformation, followed by complex congenital heart diseases (22.3%), simple left to right shunt
(12%), pulmonary atresia with ventricular septal defect (8.6%), tricuspid atresia (5.7%), simple
d-transposition of great arteries (4%), etc. From cardiac catheterization; 49 cases (28%) revealed
additional data which were surgically important, 3 cases (1.7%) resulted
in
different diagnoses.
and 3 cases (1.7%) revealed additional information which was not surgically important. Inadequate
imaging technique (36 cases, 65.5%) and limitation of technique (19 cases, 34.5%) were the
reasons for missing anatomical findings of transthoracic echocardiography. Age at the time of
echocardiography was not a significant factor affecting the accuracy. Persistent left superior vena
cava, multiple aorto-pulmonary collateral arteries, pulmonary artery anatomy, and coronary artery
anatomy were the most frequent cardiac lesions misdiagnosed by transthoracic echocardiography
that were somewhat surgically important. The incorrect echocardiographic diagnoses were
aorta-
pulmonary window, patent ductus arteriosus, and vascular ring. Thorough and extensive echocar-
diographic scanning coupled with cooperative or adequately sedated patients by an experienced
*Division of Cardiology, Department of Pediatrics,
** Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok I 0700. Thailand.
Sl12
Download:
PDF