| Transoesophageal atrial pacing combined with transthoracic two dimensional echocardiography: experience in patients operated on with arterial switch operation for transposition of the great arteries. | |
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MedLine Citation:
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PMID: 12482802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the feasibility, safety, and diagnostic accuracy of transoesophageal atrial pacing stress echocardiography (TAPSE) combined with two dimensional transthoracic echocardiography (TTE) for evaluation of coronary perfusion in patients undergoing arterial switch operation for transposition of the great arteries. DESIGN: TAPSE combined with TTE was performed at the end of cardiac catheterisation. An ischaemic response was defined as > 1.5 mm horizontal or downsloping ST segment depression or as a new or worsened wall motion abnormality. The results were compared with results of coronary angiography. SETTING: Tertiary referral centre for paediatric cardiology and cardiac surgery. PATIENTS: 25 patients, mean (SD) age 29.5 (19) months, mean (SD) weight 12.5 (3.4) kg. MAIN OUTCOME MEASURES: Target heart rate (200 beats/min) was attained in 22 of 25 (88%) patients. Electrocardiographic ischaemic changes occurred in 4 of 25 (16%) and wall motion abnormalities in 3 of 25 (12%). Coronary obstructions were found in 2 of 25 (8%) patients. RESULTS: The test was feasible in all patients, without clinical complications requiring treatment. Compared with coronary angiography, the test had a sensitivity and a specificity of 100% and 95%, respectively, for the echocardiographic stress, and of 100% and 91%, respectively, for the electrocardiographic stress. The negative predictive value was 100% for both the echocardiographic and the electrocardiographic stress tests. The positive predictive value was 66% for the echocardiographic stress and 50% for the electrocardiographic stress tests. CONCLUSIONS: In these patients TAPSE combined with TTE was feasible and safe and apparently an accurate diagnostic method for evaluation of coronary perfusion. Patients with a negative test may have a low likelihood of major coronary abnormalities and may not require coronary angiography. |
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Authors:
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E De Caro; G P Ussia; M Marasini; G Pongiglione |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 89 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2003 Jan |
Date Detail:
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Created Date: 2002-12-16 Completed Date: 2003-01-31 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 91-5 Citation Subset: AIM; IM |
Affiliation:
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Servizio di Cardiologia, Istituto G Gaslini Children's Hospital, Genoa, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Coarctation
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complications,
surgery,
ultrasonography Cardiac Pacing, Artificial / adverse effects, methods* Child Child, Preschool Coronary Angiography Coronary Circulation Echocardiography / adverse effects, methods* Echocardiography, Stress / adverse effects, methods Feasibility Studies Heart Septal Defects, Ventricular / complications, surgery, ultrasonography Humans Infant Sensitivity and Specificity Transposition of Great Vessels / physiopathology*, surgery, ultrasonography* |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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