Two-dimensional echocardiographic assessment of the aorta in infants and children with congenital heart disease.

Abstract

To determine the accuracy of two-dimensional echocardiography in the identification of congenital anomalies of the aorta, we compared two-dimensional echocardiographic with angiographic results in 261 consecutive infants and children with congenital heart disease (age 1 day to 20 years, mean 3.3 years). Two-dimensional echocardiography was performed and interpreted without knowledge of angiographic results. Complete visualization of the ascending and descending aorta and aortic arch branches was possible by two-dimensional echocardiographic examination in suprasternal, parasternal, and subcostal views of 255 patients (98%). Identification of the esophagus during swallowing aided the diagnosis of anatomic characteristics of aortic arch. One or more significant aortic arch anomalies were present on angiograms of 116 of 255 patients (46%) and were detected by twodimensional echocardiography in 110 (sensitivity 95%, 99% specificity). Anomalies detected by twodimensional echocardiography/angiography were ascending aorta hypoplasia in four/four, truncus arteriosus three/three, right aortic arch 31/31, anomalous subclavian artery 1 1/16, coarctation 27/29, and patent ductus arteriosus 53/57. We conclude that two-dimensional echocardiography can be used to determine the anatomy of the aorta in most infants and children. In selected patients, two-dimensional echocardiography may eliminate the need for angiographic examination before surgery for congenital heart disease. Circulation 70, No. 3, 417-424, 1984. NONINVASIVE IMAGING of intracardiac anatomy and various forms of congenital heart disease has been possible for several years. However, diagnosis of extracardiac abnormalities has only recently been attempted. Advances in imaging technology make feasible a detailed evaluation of the aorta in newborn infants and children. We therefore examined 261 consecutive children with congenital heart disease by two-dimensional echocardiography. A segmental approach to the aorta was necessary so that it could be visualized completely and this approach was made possible by a combination of parasternal, subcostal, and suprasternal echocardiographic scans. Findings of two-dimensional echocardiography were compared with those of angiography or at autopsy in an attempt to answer the two following questions: (1) What is the sensitivity of two-dimensional echocardiography in detecting an abnormality of the aorta in infants and children with congenital heart disease? (2)

Evaluation of aortic coarctation after surgical repair: role of magnetic resonance imaging and Doppler ultrasound.

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Diminished pulses in the lower limbs after coarctation repair suggests restenosis or persisting stenosis. Gradients can be measured from blood pressures in the upper and lower limbs.…”

Follow-up of surgical correction of aortic arch anomalies causing tracheoesophageal compression: a 38-year single institution experience

“…Accordingly, diagnostic methods have evolved from the chest radiography, barium upper gastrointestinal series, computed tomography (CT), magnetic resonance imaging (MRI), echocardiography, and angiography to help delineate the arch anomaly and any associated cardiac defects [5][6][7][8][9]. Early diagnosis and treatment, with attention to the possible development of infectious complications, has been found to reduce patient morbidity and mortality [2,8].…”

Aortic Arch Complex Anomalies: 20-Year Experience with Symptoms, Diagnosis, Associated Cardiac Defects, and Surgical Repair

“…Accordingly, diagnostic methods have evolved from the chest radiograph [16], barium upper gastrointestinal series [3], and echocardiography [10,12,20] to help delineate the arch anomaly and any associated cardiac defects. Early diagnosis and treatment, with attention to the possible development of infectious complications, has been found to reduce patient morbidity and mortality [1].…”