Abstract
Although large atrial septal defects (ASD) can usually be visualized by two-dimensional echocardiography (2DE), and QP:QS ratio can be measured by comparison of pulmonary and aortic flows by Doppler, a problem still exists when ASD's are not visualized, or coexist with valve stenoses or complex heart disease. Measurements of TASV might solve this problem. This study was designed to measure TASV's and compare them with QP:QS measured by Doppler, cath and nuclear studies in patients with proven ASD. Normal infants and children served as controls. Mean TASV were measured from subcostal views and were corrected for beam-flow intercept angle when necessary. Doppler QP:QS was measured in the PA and AO. Tricuspid outflow tract flow was substituted for PA flow when pulmonary stenosis existed. In ASD, Doppler QP:QS was compared to cath or nuclear data. Sixteen subjects, 7 with ASD (mean age 29.7± 27.7 mo), and 9 normals (mean age 24.7±26.9 mo, p=ns), were evaluated. In ASD, mean Doppler QP: QS ratio was 1.7±.43(SD) and by cath or nuclear study was 1.6 ±.29 (p=ns). Mean TASV was 36.5 ±9.0 cm/sec/sec (range 28 to 52) in ASD and was 17.8±4.0 cm/sec/ sec (range 13 to 24) in controls (p<.001). When mean TASV was compared to QP:QS, good correlation was found, r=.80, SEE=6.8 cm/ sec. TASV is an easily performed evaluation which provides considerable clinical utility for separation of patients with left-to-right shunts through ASD's from those with intact atrial septum, and mean TASV also provides information concerning shunt size.
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Marx, G., Allen, H., Goldberg, S. et al. DO TRANSATRIAL SEPTAL DOPPLER VELOCITIES (TASV) PREDICT QP:QS RATIOS?. Pediatr Res 18 (Suppl 4), 127 (1984). https://doi.org/10.1203/00006450-198404001-00206
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DOI: https://doi.org/10.1203/00006450-198404001-00206
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