Why the study?
Does Doppler echocardiography accurately estimate invasive gradients and anatomical obstruction in patients following operative repair of aortic coarctation?
Does Doppler echocardiography accurately estimate invasive gradients and anatomical obstruction in patients following operative repair of aortic coarctation?
Doppler echocardiography correlates well with invasive peak-instantaneous gradients but poorly with anatomical obstruction, suggesting a need for liberal use of angiography or MRI in post-operative aortic coarctation patients.
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May support Doppler for invasive gradients but not anatomy in repaired coarctation; leaves open optimal follow-up imaging strategies.
Sixty-six patients operated on previously for coarctation of the aorta were included in the study. There were 50 children and 16 adults. Invasive and non-invasive gradients were recorded. Anatomical obstruction was evaluated by angiography in 54 patients and the numbers and size of collaterals were quantified. The closest correlation was found between Doppler-estimated gradients and invasive peak-instantaneous gradients (r = 0.87). The relation between anatomical obstruction and invasive peak-to-peak gradients, Doppler gradients and diastolic flow ere discouraging (r = 0.64, 0.54 and 0.35). Liberal indications for angiography or magnetic resonance tomography are recommended.
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Wendel et al. (1992) studied this question.
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