Why the study?
Does Doppler color flow mapping accurately identify and localize multiple ventricular septal defects compared to angiography in patients with VSDs and elevated pulmonary ventricular pressure?
Does Doppler color flow mapping accurately identify and localize multiple ventricular septal defects compared to angiography in patients with VSDs and elevated pulmonary ventricular pressure?
Doppler color flow mapping is highly sensitive (100%) for identifying patients with multiple VSDs, performing comparably or better than angiography, suggesting that performing both techniques may be unnecessary.
Echocardiography may aid multiple VSD detection; hypothesis-generating and should not yet change diagnostic algorithms.
The purpose of this study was to compare Doppler color flow mapping with angiography and surgical observation for detection of multiple ventricular septal defects (VSDs). Only patients with elevated pulmonary ventricular pressure were included. Among 137 patients with VSDs, 38 multiple defects were identified in 25 patients echocardiographically, 34 multiple defects in 24 patients angiographically, and 21 multiple defects in 17 patients surgically. Using surgical observation as the reference standard, the sensitivity of echocardiography for identifying patients with multiple VSDs was 17 of 17 (100%) and for angiography 15 of 17 (88%). The sensitivity of echocardiography for identifying all multiple VSDs seen at operation was 19 of 21 (90%) and of angiography was also 19 of 21 (90%). In many patients, use of both techniques may no longer be necessary.
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Spevak et al. (1993) studied this question.
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