Skip to main content Accessibility help
×
Home

Correlations with operative anatomy of real time three-dimensional echocardiographic imaging of congenital aortic valvar stenosis

  • Shankar N. Sadagopan (a1), Gruschen R. Veldtman (a1), Muthukumaran C. Sivaprakasam (a1), Barry R. Keeton (a1), James P. Gnanapragasam (a1), Anthony P. Salmon (a1), Marcus P. Haw (a1) and Joseph J. Vettukattil (a1)...

Abstract

Objective: To define the anatomic characteristics of the congenitally malformed and severely stenotic aortic valve using trans-thoracic real time three-dimensional echocardiography, and to compare and contrast this with the valvar morphology as seen at surgery. Design: Prospective cross-sectional observational study Setting: Tertiary centre for paediatric cardiology Methods: All patients requiring aortic valvotomy between December 2003 and July 2004 were evaluated prior to surgery with three-dimensional echocardiography. Full volume loop images were acquired using the Phillips Sonos 7500 system. A single observer analysed the images using “Q lab 4.1” software. The details were then compared with operative findings. Results: We identified 8 consecutive patients, with a median age of 16 weeks, ranging from 1 day to 11 years, with median weight of 7.22 kilograms, ranging from 2.78 to 22 kilograms. The measured diameter of the valvar orifice, and the number of leaflets identified, corresponded closely with surgical assessment. The sites of fusion of the leaflets were correctly identified by the echocardiographic imaging in all cases. Fusion between the right and non-coronary leaflets was identified in half the patients. Dysplasia was observed in 3 patients, with 1 patient having nodules and 2 shown to have excrescences. At surgery, nodules were excised, and excrescences were trimmed. The dysplastic changes correlated well with operative findings, though statistically not significant. Conclusion: We recommend trans-thoracic real time three-dimensional echocardiography for the assessment of the congenitally malformed aortic valve, particularly to identify sites of fusion between leaflets and to measure the orificial diameter. The definition of nodularity, and the prognosis of nodules based on the mode of intervention, will need a comparative study of patients submitted to balloon dilation as well as those undergoing surgical valvotomy

Copyright

Corresponding author

Correspondence to: Dr Joseph J. Vettukattil, Consultant Paediatric Cardiologist, Southampton General Hospital, Tremona Rd, Sothampton SO16 6YD, United Kingdom. Tel: +2380 777222, Ext. 6944; Fax: +2380 794526; E-mail: joseph.vettukattil@suht.swest.nhs.uk

References

Hide All

References

Lopes LM, Damiano AP, Moreira GN, et al. The role of echocardiography as an isolated method for indicating surgery in patients with congenital heart disease. Arq Bras Cardiol 2005; 84: 381386.
Fernandes SM, Sanders SP, Khairy P, et al. Morphology of bicuspid aortic valve in children and adolescents. J Am Coll Cardiol 2004; 44: 16481651.
Reich O, Tax P, Marek J, Razek V, et al. Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome. Heart 2004; 90: 7076.
Chan KL, Liu Xing, Beauchesne LM, Burwash IG. Comparison of real-time 3-dimensional echocardiography with conventional 2-dimensional echocardiography in the assessment of structural heart disease. J Am Soc Echocardiogr 2004; 17: 976980.
Dall'Agata A, Cromme-Dijkhuis AH, Meijboom FJ, et al. Use of three-dimensional echocardiography for analysis of outflow obstruction in congenital heart disease. Am J Cardiol 1999; 83: 921925.
Espinola-Zavaleta N, Munoz-Castellanos L, Attie F, et al. Anatomic three-dimensional echocardiographic correlation of bicuspid aortic valve. J Am Soc Echocardiogr 2003; 16: 4653.
Espinal M, Fuisz AR, Nanda NC, Aaluri SR, Mukhtar O, Sekar PC. Sensitivity and specificity of transesophageal echocardiography for determination of aortic valve morphology. Am Heart J 2000; 139: 10711076.

Keywords

Correlations with operative anatomy of real time three-dimensional echocardiographic imaging of congenital aortic valvar stenosis

  • Shankar N. Sadagopan (a1), Gruschen R. Veldtman (a1), Muthukumaran C. Sivaprakasam (a1), Barry R. Keeton (a1), James P. Gnanapragasam (a1), Anthony P. Salmon (a1), Marcus P. Haw (a1) and Joseph J. Vettukattil (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed