Use of three-dimensional echocardiography for analysis of outflow obstruction in congenital heart disease

To evaluate the feasibility and accuracy of 3-dimensional (3D) echocardiogr aphy in analysis of left. and right ventricular outflow tract (LVOT and RVO T) obstruction, 30 echocardiography was performed in 28 patients (age 4 mon ths to 36 years) with outflow tract pathology. Type of lesion and relation to valves were assessed. Length and degree of obstruction were measured. Th ree-D data sets were adequate for reconstruction in 25 of 28 patients; 47 r econstructions were made. In 13 patients with LVOT obstruction, 30 echocard iography was used to study subvalvular details in 8, valvular in 13, and su pravalvular in 1. Four of these 13 patients had complex subaortic obstructi on. In 12 patients with RVOT lesions, 30 echocardiography was used to study subvalvular details in 11, valvular in 12, and supravalvular in 2. Three-d imensional reconstructions were suitable for analysis in 100% of subvalvula r LVOT, 77% valvular LVOT, 100% supravalvular LVOT, 100% subvalvular RVOT, 50% valvular RVOT, and 50% supravalvular RVOT. Twenty patients underwent op eration, and surgical findings served as morphologic control for thirty-fou r 3D reconstructions (LVOT 17, RVOT 17). Operative findings revealed an acc uracy at subvalvular LVOT of 100%, valvular LVOT 90%, supravalvular LVOT 10 0%, subvalvular RVOT 100%, valvular RVOT 100%, and supravalvular RVOT 100%. Quantitative measurements could adequately be performed. Three-D echocardi ography is feasible and accurate for analyzing both outflow tracts of the h eart. Particularly, generation of nonconventional horizontal cross sections allows a good definition of extension and severity of lesions. (C) 1999 by Excerpta Medica Inc.