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  • Title: [Comparison of 2-d-echocardiographic and hemodynamic findings in patients with atrial and ventricular septal defects (author's transl)].
    Author: Schartl M, Schartl S, Disselhoff W, Lange L, Disselhoff M.
    Journal: Z Kardiol; 1982 May; 71(5):370-6. PubMed ID: 7113329.
    Abstract:
    57 patients (age 2 to 79 years) with atrial septal defect and 28 patients (age 1 month to 60 years) with ventricular septal defect were examined to find out whether the 2-d-echo allows to predict the shunt flow and the hemodynamic parameters of the pulmonary system. In 96% of the patients with asd, the defect could be demonstrated in the subcostal view. In 68% of the patients with vsd, the defect was shown in the long axis or the subcostal view. There was a low correlation between the size of the defect and the quotient of pulmonary to systemic flow (for asd: r = 0.73; for vsd: r = 0.62). Also, the quotient of pulmonary to systemic flow related rather poorly to the quotient of pulmonary artery diameter to aortic diameter as determined in th short axis (for asdii: r = 0.75; for vsd: r = 0.73). Nor relation could be found between echocardiographic parameters and pulmonary artery pressure with one exception: if contrast-echocardiography revealed a right-to-left shunt in patients with vsd, the pulmonary pressure exceeded the systemic pressure by 50%. The results show that in patients with asd or vsd the hemodynamic situation cannot be exactly judged from echocardiographic findings alone. The consideration of several echocardiographic parameters, however, seems to allow a distinction between hemodynamically relevant and irrelevant defects, which might be helpful for clinical purposes. For patients with asd, a shunt volume of minor importance (Qp:Qs less than 1.5:1) is found if the defect does not exceed 35% of the atrial septum length and if the quotient of pulmonary to aortic diameter is less than 1. In patients with vsd, the demonstration of the defect itself and a quotient of pulmonary to aortic diameter larger than 1 means that a shunt volume with Qp:Qs greater than 1.5:1 can be expected. Unsatisfactory results concerning the pulmonary pressure are obtained even when applying the contrast-echocardiography.
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