title: Accuracy of coronary artery anatomy using two-dimensional echocardiography in d-transposition of great arteries using a two-reviewer method.
abstract: We evaluated echocardiographic accuracy for defining coronary artery course in d-transposition of great arteries and the impact of a 2-reviewer method on this accuracy. The echocardiogram reports of 108 patients with d-transposition of great arteries were reviewed for coronary anatomy and compared with the operative report. In method 1, from January 1995 to December 1997, a single reader performed the echocardiogram. In method 2, from January 1998 to December 2000, 2 readers scanned individually and a consensus diagnosis was made. Comparing methods 1 and 2, the sensitivity of the echocardiogram to detect variants in coronary anatomy was 68% versus 86%, and negative predictive value was 72% versus 91%. Using a 2-reviewer method improved the accuracy of echocardiographic diagnosis of coronary anatomy with d-transposition of great arteries, aiding in risk assessment and treatment of the patient preoperatively. This study also illustrates that echocardiographic accuracy may be lower in an institution with a surgical volume more representative of the usual pediatric cardiothoracic surgical center.
authors.affiliation: Minneapolis Children's Hospital, Minneapolis, Minnesota, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Gremmels
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Tacy
authors.forename: Michael M
authors.initials: MM
authors.lastname: Brook
authors.forename: Norman H
authors.initials: NH
authors.lastname: Silverman
mesh_terms: D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D015150:Echocardiography, Doppler; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012680:Sensitivity and Specificity; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery