Author + information
- Received March 12, 1990
- Revision received February 20, 1991
- Accepted April 22, 1991
- Published online October 1, 1991.
- Mark K. Parsons, MD,
- Gordon A. Moreau, MD,
- Thomas P. Graham Jr., MD, FACC∗,
- James A. Johns, MD and
- Robert J. Boucek Jr., MD
- ↵∗Address for reprints: Thomas P., Graham Jr MD. Professor of Pedratries, Division of Pedratric Cardiology, Venderbilt Medical Center, D-221 MCN, Nashville, Tennessee 27232 2812.
With the current trend to performing surgical valvotomy for infantile aortic stenosis without cardiac catheterization, there is a need to develop echocardiographic criteria for adequacy of left ventricular size. The echocardiograms and catheterization data of all 25 infants <3 months of age undergoing aortic valvotomy for isolated aortic valve stenosis from September 1980 through July 1990 were reviewed. Significant differences (p < 0.05) between the survivors and nonsurvivors were noted for age at operation (30 ± 28 vs. 3 ± 1.5 days), mitral valve diameter (10.1 ± 1.7 vs. 7.7 ± 1.5 mm), left ventricular end-diastolic dimension (18.4 ± 0.4 vs. 11.4 ± 3 mm), left atrial dimensions (15.3 ± 3.8 vs. 10 ± 2.4 mm). left ventricular cross-sectional area on the parasternal long-axis echocardiogram (4 ± 1.9 vs. 2 ± 1.9 cm2) and angiographically determined left ventricular end-diastolic volume (43 ± 23 vs. 11 ± 5 ml/m2).
There was no difference with respect to patient weight, body surface area, aortic root dimension or left ventricular ejection fraction. Left ventricular cross-sectional area <2 cm2as measured on the parasternal long-axis echocardiogram was found in 5 of 7 nonsurvivors and 0 of 12 survivors, making this a risk factor for perioperative death (p < 0.05). Left ventricular end-diastolic dimension <13 mm was found in 5 of 6 nonsurvivors and 2 of 17 survivors, making this another risk factor for early mortality (p < 0.05). There was good correlation between angiographic left ventricular end-diastolic volume and both left ventricular cross-sectional area and end-diastolic dimension. It is concluded that a left ventricular cross-sectional area <2 cm2in infants with critical aortic stenosis is useful as an adjunct in assessing the critical left ventricular size that is not adequate for survival after valvotomy.
- Received March 12, 1990.
- Revision received February 20, 1991.
- Accepted April 22, 1991.