Prospective detection by Doppler color flow imaging of additional defects in infants with a large ventricular septal defect

Prospective detection by Doppler color flow imaging of additional defects in infants with a large ventricular septal defect

The use of Doppler color flow imaging and axial contrast angiography in the preoperative detection of additional ventricular septal defects (in the setting of a known large defect) were compared in a prospective fashion. One hundred seventy-nine infants with two ventricles (each of at least normal s...

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Bibliographic Details
Published in:Journal of the American College of Cardiology Vol. 15; no. 7; pp. 1637 - 1642
Main Authors: Chin, Alvin J., Alboliraas, Ernerio T., Barber, Gerald, Murphy, John D., Helton, J.Gregg, Pigott, John D., Norwood, William I.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-06-1990
Elsevier Science
Subjects:
Angiography - standards
Biological and medical sciences
Cardiology. Vascular system
Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava
Echocardiography, Doppler
Evaluation Studies as Topic
Heart
Heart Septal Defects, Ventricular - diagnosis
Heart Septal Defects, Ventricular - diagnostic imaging
Humans
Infant
Infant, Newborn
Medical sciences
Predictive Value of Tests
Sensitivity and Specificity
Statistics as Topic
Human
Doppler ultrasound study
Ventricular septal defect
Congenital
Ultrasonic investigation
Color
Cardiovascular disease
Exploration
Screening
Heart disease
Surgery
Preoperative
Child
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Description
Summary:The use of Doppler color flow imaging and axial contrast angiography in the preoperative detection of additional ventricular septal defects (in the setting of a known large defect) were compared in a prospective fashion. One hundred seventy-nine infants with two ventricles (each of at least normal size) and a large, nonrestrictive ventricular septal defect underwent reparative surgery before 2 years of age. The reference standard for the presence of additional defects was intraoperadve verification or (in cases in which the surgeon did not visualize any additional defect) subsequent identification at postoperative angiography, postoperative color Doppler examination or reoperation. Only six patients (3%) had additional ventricular septal defects confirmed at the time of repair; an additional five (3%) had defects found only postoperatively. The negative predictive value of Doppler color flow imaging and angiography was 0.95 (168 of 176) and 0.97 (168 of 174), respectively. The sensitivity was 0.27 (3 of 11) and 0.45 (5 of 11), respectively. For certain malformations with a very low prevalence of additional muscular defects (such as perimembranous ventricular septal defect with normally aligned great arteries), a clinical trial of reparative surgery without prior invasive study appears reasonable.
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ISSN:0735-1097
1558-3597
DOI:10.1016/0735-1097(90)92840-X