Copyright © 1991 by the European Society of Cardiology.
© 1991 The European Society of Cardiology
The value of 2-D Doppler echocardiography in the evaluation of asymptomatic patients with Mustard operation for transposition of the great arteries
Department of Pediatrics, Division of Pediatric Cardiology, University Hospital Groningen, The Netherlands
Received 31 August 1990; revised 1 November 1990; .
Correspondence: A. H. Cromme-Dijkhuis, MD. Sophia Children's Hospital, Gordelweg 160, 3038 GE Rotterdam, The Netherlands
Abstract
2-D Doppler echocardiography was used to assess the occurrence of haemodynamic abnormalities in 45 asymptomatic patients, aged 4 to 16 years (median 7·4) after a Mustard operation for transposition of the great arteries. The findings were compared with those derived from cardiac catheterization. Thirty-five cardiac lesions were correctly diagnosed by 2-D Doppler echocardiography in 23 patients, but on six occasions, minor abnormalities were missed. 2-D Doppler echocardiography demonstrated systemic venous pathway obstruction of more than 3 mmHg at cardiac catheterization in nine patients, and in five of the six patients with pulmonary venous channel obstruction. A left ventricular outflow tract obstruction (pressure difference > 15 mmHg) was diagnosed correctly by Doppler echocardiography in seven patients. Baffle leakage was found in two patients with a left to right shunt of 25% or more of pulmonary bloodflow, but was missed in five out of nine patients with small shunts. Tricuspid regurgitation was well defined in eight patients, The absence of symptoms and a routine examination after a Mustard operation do not rule out haemodynamic abnormalities. However, these, with the possible exception of minor baffle leakage, can be detected by 2-D Doppler echocardiography.
Key Words: 2-D Doppler echocardiography • Mustard operation • congenital heart disease