Validation of two echocardiographic indexes to improve the diagnosis of complex coarctations.

Details

Ressource 1Download: serval:BIB_BBDC0F58754A.P001 (318.65 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_BBDC0F58754A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Validation of two echocardiographic indexes to improve the diagnosis of complex coarctations.
Journal
European Journal of Cardio-thoracic Surgery
Author(s)
Mivelaz Y., Di Bernardo S., Meijboom E.J., Sekarski N.
ISSN
1873-734X[electronic]
Publication state
Published
Issued date
2008
Volume
34
Number
5
Pages
1051-1056
Language
english
Abstract
OBJECTIVES: Coarctation of the aorta is one of the most common congenital heart defects. Its diagnosis may be difficult in the presence of a patent ductus arteriosus, of other complex defects or of a poor echocardiographic window. We sought to demonstrate that the carotid-subclavian artery index (CSA index) and the isthmus-descending aorta ratio (I/D ratio), two recently described echocardiographic indexes, are effective in detection of isolated and complex aortic coarctations in children younger and older than 3 months of age. The CSA index is the ratio of the distal aortic arch diameter to the distance between the left carotid artery and the left subclavian artery. It is highly suggestive of a coarctation when it is <1.5. The I/D ratio defined as the diameter of the isthmus to the diameter of the descending aorta, suggests an aortic coarctation when it is less than 0.64. METHODS: This is a retrospective cohort study in a tertiary care children's hospital. Review of all echocardiograms in children aged 0-18 years with a diagnosis of coarctation seen at the author's institution between 1996 and 2006. An age- and sex-matched control group without coarctation was constituted. Offline echocardiographic measurements of the aortic arch were performed in order to calculate the CSA index and I/D ratio. RESULTS: Sixty-eight patients were included in the coarctation group, 24 in the control group. Patients with coarctation had a significantly lower CSA index (0.84+/-0.39 vs 2.65+/-0.82, p<0.0001) and I/D ratio (0.58+/-0.18 vs 0.98+/-0.19, p<0.0001) than patients in the control group. Associated cardiac defects and age of the child did not significantly alter the CSA index or the I/D ratio. CONCLUSIONS: A CSA index less than 1.5 is highly suggestive of coarctation independent of age and of the presence of other cardiac defects. I/D ratio alone is less specific than CSA alone at any age and for any associated cardiac lesion. The association of both indexes improves sensitivity and permits diagnosis of coarctation in all patients based solely on a bedside echocardiographic measurement.
Keywords
Aorta, Thoracic/pathology, Aorta, Thoracic/ultrasonography, Aortic Coarctation/pathology, Aortic Coarctation/ultrasonography, Carotid Arteries/pathology, Carotid Arteries/ultrasonography, Child, Preschool, Diagnostic Errors, Female, Humans, Image Interpretation, Computer-Assisted/methods, Infant, Infant, Newborn, Male, Retrospective Studies, Subclavian Artery/pathology, Subclavian Artery/ultrasonography
Pubmed
Web of science
Open Access
Yes
Create date
03/10/2009 12:16
Last modification date
25/09/2019 7:10
Usage data