Clinical utility of two-dimensional Doppler echocardiographic techniques for estimating pulmonary to systemic blood flow ratios in children with left to right shunting atrial septal defect, ventricular septal defect or patent ductus arteriosus

Abstract

Range gated two-dimensional Doppler echocardiographic methods were evaluated for quantifying pulmonary (QP) to systemic (QS) blood flow ratios. Twenty-one patients were studied, 4 with patent ductus arteriosus, 6 with atrial septal defect and 11 with ventricular septal defect. The Doppler pulmonary to systemic flow (QP:QS) estimation method involved calculating volume flow (liters/min) at a variety of intracardiac sites by using imaging information for flow area and Doppler outputs to calculate mean flow velocity as a function of time. Area volume flows were combined to yield QP:QS ratios. The sites sampled were main pulmonary artery, ascending aorta, mitral valve orifice and subpulmonary right ventricular outflow tract. The overall correlation between Doppler QP:QS estimates and those obtained at cardiac catheterization (n = 18) or radionuclide angiography (n = 3) was r = 0.85 (standard error of the estimate = 0.48:1). These preliminary results suggest that clinical application of this Doppler echocardiographic method should allow noninvasive estimation of the magnitude of cardiac shunts.

Impact of Chronic Left Ventricular Preload and Afterload on Doppler Tissue Imaging Velocities: A Study in Congenital Heart Disease

“…[14][15][16][17][18][19]30,[32][33][34][35][36][37][38][39] Recent studies in children, however, have demonstrated that DTI velocities are not only influenced by aging but also more significantly by changes in LV growth parameters, most notably LV end-diastolic dimension and LV mass. 25 Children with congenital heart disease often have distorted ventricular geometry caused by significant alterations in hemodynamic loading conditions.…”

“…[31][32][33][34] Patients with isolated aortic valve stenosis (AS) comprised a group of patients with increased LV afterload. This group consisted of 96 patients with varying severity of LV outflow obstruction.…”

Surface Integration of Velocity Vectors from 3D Digital Colour Doppler: An Angle Independent Method for Laminar Flow Measurements

“…This can be used clinically to measure blood flow within the heart and great vessels, providing potential not only to determine cardiac output [1][2][3] but also to quantify shunt flow and regurgitant volumes on the basis of flow differences through the individual valves [4] .…”

Assessment of Ventricular Septal Defect Size and Morphology by Three-Dimensional Transthoracic Echocardiography

“…1 Two-dimensional (2D) transthoracic echocardiography (TTE) is usually sufficient to assess the anatomy and hemodynamics of a VSD and guide clinical management. 1,2 Recently, percutaneous closure of muscular as well as membranous VSDs using different devices has emerged as an alternative to the surgical technique in selected cases. [3][4][5][6] An accurate assessment of the size and morphology of a VSD is of crucial importance in these cases for device choice.…”