Document Detail


Significance of the Doppler-derived gradient across a residual aortic coarctation.
MedLine Citation:
PMID:  2304885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Few data exist which address the significance of the Doppler gradient across a residual narrowing in older children who have had a coarctation repaired. Therefore, we evaluated 11 patients with repaired aortic coarctation with and without residual obstruction by Doppler echocardiography. The Doppler-derived transcoarctation pressure gradient correlated poorly with catheter-measured peak-to-peak and catheter maximal instantaneous gradients when only the maximal velocity across the repair was utilized in the simplified Bernoulli equation, [r = 0.73, standard of error of the estimate (SEE) = 5.0 mmHg and r = 0.56, SEE = 7.6 mmHg, respectively]. However, when the precoarctation velocity was included in the simplified Bernoulli equation, the correlation between Doppler-derived and catheter-measured gradients became excellent. The maximal Doppler gradient correlated well with catheter peak-to-peak gradient (r = 0.95, SEE = 2.2 mmHg) and catheter maximal instantaneous gradient (r = 0.94, SEE = 3.2 mmHg). However, the maximal Doppler gradient slightly overestimated the catheter peak-to-peak gradient and underestimated the catheter maximal instantaneous gradient. The Doppler mean gradient showed excellent correlation with the catheter mean gradient (r = 0.97, SEE = 0.85 mmHg). Precoarctation velocities were generally twofold greater than published normals due to a spatial acceleration phenomenon. All subjects had residual hypoplasia of the transverse aorta such that its transverse diameter was 29% less than, and its cross-sectional area was 50% less than, the ascending and descending aorta.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A W Aldousany; T G DiSessa; B S Alpert; S E Birnbaum; E S Willey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric cardiology     Volume:  11     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  1990 Jan 
Date Detail:
Created Date:  1990-03-29     Completed Date:  1990-03-29     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  8-14     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Tennessee, School of Medicine, Memphis.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aortic Coarctation / diagnosis*,  physiopathology,  surgery
Blood Flow Velocity
Child
Child, Preschool
Echocardiography, Doppler / methods*
Female
Heart Catheterization
Humans
Infant
Male
Postoperative Complications / diagnosis,  physiopathology

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