Two-dimensional echocardiographic assessment of pulmonary artery and aortic arch anatomy in cyanotic infants
HP Gutgesell,
JC Huhta,
MH Cohen,
and
LA Latson
To determine the feasibility and accuracy of noninvasive assessment of pulmonary artery and aortic arch anatomy, a prospective two-dimensional echocardiographic evaluation was performed in 20 consecutive cyanotic infants before cardiac catheterization and angiography. The echocardiographic assessment was correct with the following frequency: detection of left aortic arch in 13 of 13 infants, detection of right aortic arch in 7 of 7, identification of patent ductus arteriosus in 13 of 13 (one false positive finding), identification of a right pulmonary artery in 20 of 20, identification of a left pulmonary artery in 19 of 20, identification of the confluence of the right and left pulmonary arteries in 19 of 20 and identification of a main pulmonary artery in 14 of 16 (two false positive diagnoses by echocardiography). Echocardiographic estimates of arterial diameters were slightly smaller than those obtained by angiography. Mean vessel size (echocardiographic/angiographic diameter) was as follows: transverse aortic arch 8.6/10.6 mm, main pulmonary artery 5.7/6.3 mm, right pulmonary artery 4.1/4.2 mm and left pulmonary artery 4.2/3.9 mm. It is concluded that although two-dimensional echocardiography tends to underestimate vessel size, the qualitative assessment is adequate for planning a systemic to pulmonary artery anastomosis in selected infants with cyanotic forms of congenital heart disease.
