Echocardiographic visualization of ventricular septal defect in infants and assessment of hemodynamic status using a contrast technique. Comparison of M-mode and two-dimensional imaging.
Twenty-seven patients with ventricular septal defect (VSD), ages 2 months to 2 years, were evaluated by both M-mode and two-dimensional echocardiography (2-D echo) with the aid of a peripheral venous contrast technique. M-mode echocardiography was unreliable for imaging VSD. Using 2-D echo, defects in the interventricular septum were visualized in all patients examined; defects in the membranous portion (24 patients) were visualized by the subcostal frontal approach and defects in the supracristal portion (three patients) by the subcostal sagittal approach. The 2-D echo contrast study revealed negative contrast jets appearing through the defect in the right ventricle in 22 patients with a pulmonary-to-systemic blood flow ratio greater than 2.0, and positive contrast jets appearing through the defect in the left ventricle in 13 patients with a right-to-left ventricular peak pressure ratio greater than 0.71. We conclude that 2-D echo with peripheral contrast technique confirmed the anatomic location of VSD and indicated the approximate right-to-left ventricular peak pressure ratio, showing the contrast material shunting through the defect itself.
D006328:Cardiac Catheterization; D002675:Child, Preschool; D003287:Contrast Media / Q000494:pharmacology*; D004452:Echocardiography; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis*; D006439:Hemodynamics; D006801:Humans; D007223:Infant
D003287:Contrast Media