The value of 2-D Doppler echocardiography in the evaluation of asymptomatic patients with Mustard operation for transposition of the great arteries.
2-D Doppler echocardiography was used to assess the occurrence of haemodynamic abnormalities in 45 asymptomatic patients, aged 4 to 16 years (median 7.4) after a Mustard operation for transposition of the great arteries. The findings were compared with those derived from cardiac catheterization. Thirty-five cardiac lesions were correctly diagnosed by 2-D Doppler echocardiography in 23 patients, but on six occasions, minor abnormalities were missed. 2-D Doppler echocardiography demonstrated systemic venous pathway obstruction of more than 3 mmHg at cardiac catheterization in nine patients, and in five of the six patients with pulmonary venous channel obstruction. A left ventricular outflow tract obstruction (pressure difference greater than 15 mmHg) was diagnosed correctly by Doppler echocardiography in seven patients. Baffle leakage was found in two patients with a left to right shunt of 25% or more of pulmonary blood flow, but was missed in five out of nine patients with small shunts. Tricuspid regurgitation was well defined in eight patients. The absence of symptoms and a routine examination after a Mustard operation do not rule out haemodynamic abnormalities. However, these, with the possible exception of minor baffle leakage, can be detected by 2-D Doppler echocardiography.
Cromme-Dijkhuis
A H
AH
Department of Pediatrics, University Hospital, Groningen, The Netherlands.
Schasfoort-van Leeuwen
M
M
Bink-Boekens
M T
MT
Talsma
M
M
D006328:Cardiac Catheterization; D002648:Child; D015150:Echocardiography, Doppler; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012307:Risk Factors; D014188:Transposition of Great Vessels / Q000601:surgery*