[Heart surgery without previous heart catheterization, in pediatric cardiology].
OBJECTIVE
To determine the influence of echocardiography in the preoperative diagnosis of heart diseases in children.


METHODS
Retrospective study.


METHODS
Hospitalized children admitted in Departments of Pediatric Cardiology and Cardiothoracic Surgery.


METHODS
Children of both sexes, aged from neonate to 14 years old, with heart disease who underwent cardiac surgery.


METHODS
From January 1989 to July 1990, 220 consecutive cardiac surgeries were performed in children with heart disease. The initial diagnosis was based on data from clinical examination, electrocardiogram, thorax X-Ray and echocardiogram (M-mode, 2D, conventional and colour Doppler). Patients were separated in three groups according to their ages: newborn infants less than 28 days old; infants less than 12 months old; children more than 1 year old and less than 14 years old. Patients were separated according to the investigations used further for preoperative diagnosis: whether they had or not cardiac catheterization performed prior to surgery.


RESULTS
From 220 surgical interventions performed, 124 were "open heart" surgeries (9 neonates, 28 infants and 87 children) and the remaining had "closed heart" operations (14 neonates, 37 infants and 45 children). Preoperative diagnosis was mainly dependent on echocardiography, dispensing catheterization in 90 cardiac interventions. The diagnosis was confirmed at surgery or at autopsy. There were 9 deaths, 3 of which occurred in patients not submitted to cardiac catheterization.


CONCLUSIONS
Echocardiography is a reliable method for investigation and establishment of the preoperative diagnosis of heart diseases in children. Its use may further reduce the need for diagnostic catheterization in children, particularly in risk groups.
Ferreira
M
M
Serviço de Cardiologia Pediátrica, do Hospital de Santa Marta, Lisboa.
Pinto
F
F
Macedo
A
A
Banazol
N
N
Franco
C
C
Magalhães
M P
MP
Lima
M
M
D000293:Adolescent; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011300:Preoperative Care
Cirurgia cardíaca sem cateterismo cardíaco prévio, em cardiologia pediátrica.