[The role of echocardiography as an isolated method for indicating surgery in patients with congenital heart disease].
OBJECTIVE
To determine the diagnostic accuracy of echocardiography for indicating surgery without catheterization in patients with congenital heart disease through a prospective analysis and comparison of the echocardiographic diagnosis with the intraoperative findings, or invasive study, or both.


METHODS
From February 2000 to January 2001, 493 patients with congenital heart diseases indicated for surgery were followed up. They underwent echocardiography with color-flow mapping for a therapeutic decision. The results were compared with the findings of surgery or catheterization, or both, when the latter were performed for diagnostic reasons.


RESULTS
Of the patients studied, 94.3% (465 cases) underwent congenital heart disease correction based only on echocardiographic findings, without a diagnostic catheterization. The invasive study was performed for diagnostic reasons in 28 (5.6%) patients, the surgical treatment was performed in more than 95% of the patients, and therapeutic catheterization was performed in 3.6%. The echocardiographic findings were confirmed in 464 (94.1%) patients, which showed the high accuracy of the method. False-positive findings occurred in 8 (1.6%) patients, and false-negative findings in 39 (7.9%). According to surgeons, no diagnostic error led to complications or adversely affected the surgical results.


CONCLUSIONS
Echocardiography proved to be a sensitive and safe method for indicating surgery, making catheterization, often, unnecessary. The invasive study was restricted to diagnostic or therapeutic uses.
Lopes
Lilian Maria
LM
Hospital Beneficência Portuguesa, São Paulo, SP. lilianlopes@ecokid.com.br
Damiano
Ana Paula
AP
Moreira
Gláucia Neusa Oliveira
GN
Azevedo
Terezinha J F
TJ
Nagamatsu
Célia Toshie
CT
Tavares
Gláucia Maria Penha
GM
Guerra
Victor Coimbra
VC
Silva
José Pedro da
JP
Furlanetto
Gláucio
G
Salvador
André Bavaresco Cristóvão
AB
D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler / Q000592:standards*; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care