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Pediatric Cardiology

, Volume 39, Issue 8, pp 1523–1529 | Cite as

Feasibility of Transthoracic Echocardiography Evaluation of Pulmonary Arteries Following Arterial Switch Operation

  • Sean M. Lang
  • R. Lee Crawford
  • Pushpa Shivaram
  • Joshua A. Daily
  • Elijah H. Bolin
  • Xinyu Tang
  • R. Thomas CollinsII
Original Article

Abstract

Pulmonary artery (PA) stenosis is the most common late sequela following arterial switch for d-transposition of the great arteries. The purpose of this study was to assess the effectiveness of transthoracic echocardiography in evaluating the pulmonary arteries following repair. This was a retrospective, cross-sectional analysis of all echocardiograms performed on patients following arterial switch operation. A numerical scoring system was devised and used to quantify PA visualization based on 2D images, color mapping, and spectral Doppler. The study cohort included 150 patients. The ability to visualize at least one PA was poorer in patients who were older [> 10 years (47%) vs ≤ 10 years (89%) (p < 0.001)], and who had larger body surface area (BSA) (> 1.25 m2 (40%) vs ≤ 1.25 m2 (90%) (p < 0.001)]. Regardless of age, 2D visualization of the pulmonary arteries was poor for the entire cohort. Of those with at least one non-visualized PA, only 54% had alternative imaging performed or ordered within the 5 years at or prior to their last echocardiogram. In conclusion, PA visualization following arterial switch is worse in patients who are older and in those with larger BSA. In such patients, alternative forms of imaging are more likely to be necessary.

Keywords

LeCompte Transposition Pediatric Congenital heart disease 

Abbreviations

ASO

Arterial switch operation

BSA

Body surface area

CMR

Cardiac magnetic resonance imaging

CT

Computed tomography

d-TGA

d-Transposition of the great arteries

PA

Pulmonary artery

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors. Our institution IRB approved the study; it consisted of a retrospective review of de-identified patient information; no procedures were performed on human or animal subjects; and informed consent was not obtained.

Supplementary material

246_2018_1924_MOESM1_ESM.tif (207 kb)
Supplemental Fig. 1—ROC for predicting PA visualization score > 8, using years as a linear effect (TIF 206 KB)
246_2018_1924_MOESM2_ESM.tif (183 kb)
Supplemental Fig. 2—ROC for predicting PA visualization score ≥ 8 using BSA as a linear effect (TIF 182 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sean M. Lang
    • 1
  • R. Lee Crawford
    • 2
    • 4
  • Pushpa Shivaram
    • 2
    • 3
    • 4
  • Joshua A. Daily
    • 2
    • 3
    • 4
  • Elijah H. Bolin
    • 2
    • 3
    • 4
  • Xinyu Tang
    • 3
    • 4
  • R. Thomas CollinsII
    • 5
  1. 1.The Heart InstituteCincinnati Children’s Medical CenterCincinnatiUSA
  2. 2.Arkansas Children’s HospitalLittle RockUSA
  3. 3.Arkansas Children’s Research InstituteLittle RockUSA
  4. 4.University of Arkansas for Medical SciencesLittle RockUSA
  5. 5.Lucille Packard Children’s HospitalStanford UniversityPalo AltoUSA

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