All issues > Volume 44(2); 2001

Original Article

J Korean Pediatr Soc. 2001;44(2):154-160. Published online February 15, 2001.

Diagnostic Assessment of Pulmonary Atresia with Ventricular Septal Defect; Comparison of Echocardiogram with Cardiac Angiography

Jung Yun JY Choi¹, Jeong Jin JJ Yu¹, Soo Jung SJ Kang¹, Jae Seong JS Son¹, Young Mee YM Seo¹, Jin Young JY Song¹, Ho Sung HS Kim¹, Eun Jung EJ Bae¹, Chung Il CI Noh¹, Yong Soo YS Yun¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Abstract

Purpose
: Patients with pulmonary atresia with ventricular septal defects(PAVSD) have been a formidable surgical challenge. The source of pulmonary blood flow and vascular architecture are important in managing the surgical process. This study aimed to evaluate the usefulness of echocardiography in this process.
Methods
: This study was prospectively designed to define the role of echocardiography in PAVSD. Non-invasive evaluations including echocardiography were done, catheterization/angiography was performed the next day and the results were compared with those of echocardiography. The study population consisted of 9 patients, diagnosed as PAVSD in our hospital, from Jan. 1995 to Dec. 1997.
Results
: Pulmonary blood was supplied via ductus arteriosus, in 3 patients(group 1), and in the other 6 patients, via major aortopulmonary collateral arteries(MAPCA)(group 2). The characteristic findings of group 2 were cardiac murmur heard in the back area(3 cases), and abnormal pulmonary arborization pattern(2 cases). The echocardiographic diagnosis of source of pulmonary blood flow was correct in all cases except one case-who had had two previous shunt surgeries and additional MAPCAs. In group 2, the presence of pulmonary confluence was predicted in 3 out of 4 cases. The mean number of MAPCAs found by echocardiography was 2.3¡¾1.2 and by angiography, 3.5¡¾1.4.
Conclusion
: In evaluation of PAVSD patients, near complete characteristics of pulmonary blood supply were identified by echocardiogram. Using it, practitioners can make decisions for shunt surgery or the need for further evaluations, including cardiac catheterization which can be more easily executed with previous echocardiographic data.

Keywords :Pulmonary atresia, Major aortopulmonary collateral artery