TY - JOUR
T1 - Contrast echocardiographic shunts may persist after atrial septal defect repair
AU - Sukamto, Teguh Santoso
AU - Meltzer, R. S.
AU - Castellanos, S.
AU - Serruys, P. W.
AU - Roelandt, J.
PY - 1983/2
Y1 - 1983/2
N2 - We performed contrast echocardiography on 19 subjects who were asymptomatic in the postoperative period after surgical repair of atrial septal defects. Eighteen of these subjects had adequate right heart echocardiographic contrast to assess the presence or absence of right-to-left shunting. Multiple M-mode and two-dimensional echocardiographic views were studied during several contrast injections with and without the Valsalva manoeuvre. Six patients had postoperative shunts and 12 patients had no postoperative shunts. The age of the six patients with postoperative shunts was 26 ± 10 years (mean ± s.d.) and that of the 12 patients without postoperative shunts was 39 ± 14 years.Four out of six of the postoperative shunt group were males and of these three had patch repairs compared with two males out of 12 with patch repair in the no shunt group. There were no definite differences between the two groups in the following variables: type of atrial septal defect (primum v. secundum), pre-operative shunt size, pre-operative peak right ventricular pressure, pre-operative New York Heart Association functional class, pre- or postoperative right ventricular or left ventricular dimensions, aortic and left atrial dimensions. Four of the six patients with postoperative contrast echo shunting underwent cardiac catheterization, showing no significant step-up in oxygen saturation in three, and a significant shunt in one patient who had patch dehiscence at re-operation. We conclude that right-to-left shunts as demonstrated by contrast echocardiography are common in the late postoperative period after atrial septal defect repair. They need not indicate unsuccessful repair or a haemodynamically important residual shunt.
AB - We performed contrast echocardiography on 19 subjects who were asymptomatic in the postoperative period after surgical repair of atrial septal defects. Eighteen of these subjects had adequate right heart echocardiographic contrast to assess the presence or absence of right-to-left shunting. Multiple M-mode and two-dimensional echocardiographic views were studied during several contrast injections with and without the Valsalva manoeuvre. Six patients had postoperative shunts and 12 patients had no postoperative shunts. The age of the six patients with postoperative shunts was 26 ± 10 years (mean ± s.d.) and that of the 12 patients without postoperative shunts was 39 ± 14 years.Four out of six of the postoperative shunt group were males and of these three had patch repairs compared with two males out of 12 with patch repair in the no shunt group. There were no definite differences between the two groups in the following variables: type of atrial septal defect (primum v. secundum), pre-operative shunt size, pre-operative peak right ventricular pressure, pre-operative New York Heart Association functional class, pre- or postoperative right ventricular or left ventricular dimensions, aortic and left atrial dimensions. Four of the six patients with postoperative contrast echo shunting underwent cardiac catheterization, showing no significant step-up in oxygen saturation in three, and a significant shunt in one patient who had patch dehiscence at re-operation. We conclude that right-to-left shunts as demonstrated by contrast echocardiography are common in the late postoperative period after atrial septal defect repair. They need not indicate unsuccessful repair or a haemodynamically important residual shunt.
KW - Atrial septal defect
KW - Contrast echocardiography
KW - Echocardiography
KW - Right-to-left shunt
UR - http://www.scopus.com/inward/record.url?scp=0020662428&partnerID=8YFLogxK
U2 - 10.1093/oxfordjournals.eurheartj.a061427
DO - 10.1093/oxfordjournals.eurheartj.a061427
M3 - Article
C2 - 6852068
AN - SCOPUS:0020662428
VL - 4
SP - 129
EP - 136
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 2
ER -