TRANSTELEPHONIC ECHOCARDIOGRAPHY - SUCCESSFUL USE IN A TERTIARY PEDIATRIC REFERRAL CENTER

Recent advances in computers and telecommunications hove mode transtel ephonic echocardiography practical. Our institution is developing a ne twork of transmissional echocardiographic sites at several hospitals i n our referral region. We reviewed our initial experience to determine whether transmissional echocardiographic studies (1) gave an appropri ate diagnostic impression compared with subsequent videotape review an d (2) led to appropriate clinical management (i.e., transfer to a tert iary center or continuation of local care and follow-up). From Aug. 1, 1991, to May 31,1992, we evaluated 47 transmissional studies (diagnos es: 24 normal, 8 potent ductus arteriosus, 6 ventricular septal defect , 2 pulmonary stenosis, 1 ventricular septal defect with interrupted a ortic arch, and 6 miscellaneous). Of 47 studies, 39 (83%) were thought to give accurate diagnostic impressions compared with videotape revie w. Most inaccuracies were due to the selection and transmission of inc onclusive information in an otherwise accurate diagnostic study. Only 1 (2%) of 47 studies resulted in an inappropriate clinical decision; a patient's transfer for treatment of a patent ductus arteriosus was de layed i day because of an inconclusive transmissional study. We conclu de that transmissional echocardiography is useful in the management of pediatric patients with suspected heart disease in a regional referra l setting.