Erroneous diagnosis of significant obstruction by Doppler in a patient with discrete subaortic membrane: correct diagnosis by 3D-transthoracic echocardiography.
We report an adult with a discrete subaortic membrane in whom two-dimensional transthoracic Doppler echocardiography demonstrated peak and mean gradients of 64 and 33 mmHg, respectively in the left ventricular outflow tract (LVOT) and a calculated orifice area by continuity equation of 1.14 cm(2) consistent with significant obstruction. However, by direct en face visualization of the LVOT at the level of the membrane by live/real time three-dimensional transthoracic echocardiography (3D TTE), a larger orifice measuring 2.29 cm(2) was seen and was indicative of no significant obstruction. This finding was confirmed at cardiac catheterization, which showed insignificant obstruction.
Bandarupalli
Naveen
N
Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35249, USA.
Faulkner
Michael
M
Nanda
Navin C
NC
Pothineni
Koteswara R
KR
D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D003951:Diagnostic Errors / Q000517:prevention & control*; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans