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Utility of expert focused cardiac ultrasound in paediatric cardiology outreach clinics

Published online by Cambridge University Press:  18 November 2019

Kristina K. Rauser-Foltz
Affiliation:
Department of Pediatrics, Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska Medical Center and Children’s Hospital and Medical Center, Omaha, NE, USA
David A. Danford
Affiliation:
Department of Pediatrics, Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska Medical Center and Children’s Hospital and Medical Center, Omaha, NE, USA
Jennifer K. Strawn
Affiliation:
Department of Pediatrics, Dr. C.C. and Mabel L. Criss Heart Center, University of Nebraska Medical Center and Children’s Hospital and Medical Center, Omaha, NE, USA
Shelby Kutty*
Affiliation:
Taussig Heart Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
*
Author for correspondence: S. Kutty, MD, PhD, MHCM, The Helen B Taussig Professor, Taussig Heart Center, Johns Hopkins University School of Medicine, 1800 Orleans St., Baltimore, MD 21287, USA. Tel: 410 502 3350; E-mail: skutty1@jhmi.edu

Abstract

Objective:

This prospective observational study evaluates the utility of expert focused cardiac ultrasound (eFCU) with spectral Doppler to inform decision making in established patients with specific, selected congenital cardiac defects in outreach clinics. Secondary objectives include determining if the addition of eFCU expands capacity in paediatric cardiology outreach clinics and if it improves the patient experience.

Methods:

Patients aged 2 months to 19 years old with a diagnosis of ventricular septal defect, atrial septal defect, atrioventricular septal defect, patent ductus arteriosus, aortic valve stenosis, or pulmonary valve stenosis with the need for follow-up echocardiography in an outreach clinic from August 2017 to June 2018 were studied. A novel assessment tool was used to determine the success of eFCU.

Results:

Forty-two patients from 11 clinics underwent eFCU with one unsuccessful exam making the failure rate 2.3% (95% CI 0.0006–0.1256). Addition of eFCU led to a significant increase in volume of patients able to be seen 19 versus 15.5 (p < 0.01). A majority of parents/patients reported a positive experience with eFCU.

Conclusion:

Expert focused cardiac ultrasound with spectral Doppler can be used successfully for follow-up in patients with select CHD and the addition of eFCU permits increased patient capacity in outreach clinics and has the potential to improve the patient experience.

Type
Original Article
Copyright
© Cambridge University Press 2019 

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