ECHOCARDIOGRAPHIC ASSESSMENT OF SHUNT VOL UME IN CHILDREN WITH ATRIALSEPTAL-DEFECT

The accuracy of echocardiographic estimation of left-to-right shunts w as studied prospectively in children with secundum ASD. Fifty-one cons ecutive patients were examined from March 1987 to August 1991. Mean ag e was 64/12 years with a minimum age of 12/12 and a maximum of 131/12 years. Twenty-five children were included in the first part of the stu dy. The ratios of right and left atrial and ventricular areas and pulm onary and aortic diameters were correlated with the left-to-right shun ts determined by oximetry (mean shunt 48.7 %; min. 10.1 %, max. 73.2 % ). The pulmonary/aortic diameter ratio provided the closest correlatio n (r = 0.95; p < 0.01). During the second part of the study the left-t o-right shunt was estimated using the regression equations developed f rom part one. Thus, in 26 subsequent patients these values were compar ed with oximetric shunt values. Again, the pulmonary/aortic diameter r atio provided the closest correlation (r = 0.97). The pair comparison yielded a difference of 0.7 +/- 3.8 %. Based on these results since 19 91, surgery for ASD II has been performed without preoperative cardiac catheterization in 33 patients, provided echocardiographic shunt esti mation was greater-than-or-equal-to 48%.