caa a22 4500 388116366 CHVBK 20180307125407.0 cr unu---uuuuu 161130e199911 xx s 000 0 eng 10.1017/S1047951100005576 doi S1047951100005576 pii (NATIONALLICENCE)cambridge-10.1017/S1047951100005576 Transthoracic 3-dimensional echocardiography in the assessment of subaortic stenosis due to a restrictive ventricular septal defect in double inlet left ventricle with discordant ventriculoarterial connections [Elektronische Daten] Abstract To evaluate the accuracy and clinical utility of three-dimensional echocardiography in the assessment of the size and shape of the ventricular septal defect in double inlet left ventricle. Methods We validated the technique in an autopsy study, and then performed a clinical investigation. Six autopsied hearts were immersed in a waterbath and examined with 3-dimensional echocardiography. We identified the cross-section within the dataset which optimally displayed the ventricular septal defect "en face”, and compared its smallest and largest diameters, as well as its area. The ventricular septal defect was then filled with a silicone sealant and a section prepared for direct measurement. In patients, we measured the diameters and area of the ventricular septal defect in endsystole nad computed the aortic valvar area in endsystole from the cross-section showing the aortic valve "en face”. Ten patients with double inlet left ventricle, aged between 2 and 15 years, were studied using rotational or parallel scanning. All patients had undergone banding of the pulmonary trunk at a mean age of 7 (3-36) days, usually at the time of repair of the coarctation. Two patients had undergone surgical enlargement of the ventricular septal defect prior to echocardiographic examination. Results The correlation between the areas of the ventricular septal defect in the specimens measured directly and by 3-dimensional echocardiography was r=0.98, with limits of agreement between −0.1- 0.08 cm2. In the patients, the area of the defect was measured as 3.9±2 cm2, whereas the aortic valvar area was 2.6±0.9 cm2. The ratio between the areas was 1.5 (0.5-2.3). Three patients with areas of the ventricular septal defect smaller than those of the aortic valve had resting Doppler gradients between double inlet left ventricle and the aorta of 16, 20 and 30 mm Hgs, respectively. Conclusions 3-dimensional echocardiography provides accurate assessment of the area of the ventricular septal defect in double inlet left ventricle, and is helpful in identifying patients with subaortic stenosis caused by restrictive defects. Copyright © Cambridge University Press 1999 three-dimensional echocardiography nationallicence double inlet left ventricle nationallicence subaortic obstruction nationallicence Vogel Michael Department Congenital Heart Disease, Deutsches Herzzentrum, Berlin, Germany Ho S. Yen National Heart and Lung Institute, Imperial College School of Medicine, London, UK Anderson Robert H. National Heart and Lung Institute, Imperial College School of Medicine, London, UK Redingtont Andrew N. Great Ormond Street Hospital, London, UK Cardiology in the Young Cambridge University Press 9/6(1999-11), 549-555 1047-9511 9:6<549 1999 9 CTY https://doi.org/10.1017/S1047951100005576 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S1047951100005576 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Vogel Michael Department Congenital Heart Disease, Deutsches Herzzentrum, Berlin, Germany NATIONALLICENCE 700 1- Ho S. Yen National Heart and Lung Institute, Imperial College School of Medicine, London, UK NATIONALLICENCE 700 1- Anderson Robert H. National Heart and Lung Institute, Imperial College School of Medicine, London, UK NATIONALLICENCE 700 1- Redingtont Andrew N. Great Ormond Street Hospital, London, UK NATIONALLICENCE 773 0- Cardiology in the Young Cambridge University Press 9/6(1999-11), 549-555 1047-9511 9:6<549 1999 9 CTY CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge