Author + information
- Received March 12, 1984
- Revision received June 12, 1984
- Accepted June 22, 1984
- Published online November 1, 1984.
- Guy S. Reeder, MD, FACC*,1,
- Philip J. Currie, MBBS1,
- Derek A. Fyfe, MD, PhD1,
- Donald J. Hagler, MD, FACC1,
- James B. Seward, MD, FACC1 and
- A. Jamil Tajik, MD, FACC1
- ↵*Address for reprints: Guy S. Reeder, MD, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Extracardiac valved conduits are often employed in the repair of certain complex congenital heart defects; late obstruction is a well recognized problem that usually requires catheterization for definitive diagnosis. A reliable noninvasive method for detecting conduit stenosis would be clinically useful in identifying the small proportion of patients who develop this problem. Continuous wave Doppler echocardiography has been used successfully to estimate cardiac valvular obstructive lesions noninvasively.
Twenty-three patients with prior extracardiac conduit placement for complex congenital heart disease underwent echocardiographic and continuous wave Doppler echocardiographic examinations to determine the presence and severity of conduit stenosis. In 20 of the 23 patients, an adequate conduit flow velocity profile was obtained, and in 10 an abnormally increased conduit flow velocity was present. All but one patient had significant obstruction proven at surgery and in one patient, surgery was planned. In three patients, an adequate conduit flow velocity profile could not be obtained but obstruction was still suspected based on high velocity tricuspid regurgitant Doppler signals. In these three patients, subsequent surgery also proved that conduit stenosis was present.
Doppler-predicted gradients and right ventricular pressures showed an overall good correlation (r = 0.90) with measurements at subsequent cardiac catheterization. Continuous wave Doppler echocardiography appears to be a useful noninvasive tool for the detection and semiquantitation of extracardiac conduit stenosis.
- Received March 12, 1984.
- Revision received June 12, 1984.
- Accepted June 22, 1984.
- American College of Cardiology Foundation