Circulation, Vol 57, 269-277, Copyright © 1978 by American Heart Association
RM Bini, KR Bloom, JA Culham, RM Freedom, CM Williams and RD Rowe
A prospective clinical and echocardiographic diagnosis of single ventricle
was made in 42 patients. Each was evaluated for the number of
atrioventricular (A/V) valves, presence of an outflow chamber (OC), A/V
valve-semilunar continuity, and orientation of the great arteries.
Angiographic correlations were subsequently obtained in 40 and autopsies in
12. The overall diagnosis of single ventricle was substantiated in 39. Two
other patients diagnosed as single ventricle by angiography were thought to
have large ventricular septal defects on echocardiography. Tricuspid valve
was interpreted as septum in one. The angiographic diagnosis of single
ventricle was incorrect in another, correctly diagnosed by echocardiography
and confirmed at pathology. The differential diagnosis also included A-V
canal, L-transposition of the great arteries, double outlet right
ventricle, and tricuspid atresia. This last condition has to be
differentiated on clinical evidence. The echocardiograms were of particular
value in determining the number of A/V valves. Two great arteries were
demonstrated in 74% of patients and their relationship was correctly
determined in 79% of these. Both imaging techniques agreed closely as to
A/V valve-semilunar continuity and presence of an OC, but both showed some
inaccuracies compared to pathological specimens. The echocardiogram helps
both in planning catheterization and in evaluating the overall diagnosis.
ARTICLES
The reliability and practicality of single crystal echocardiography in the evaluation of single ventricle. Angiographic and pathological correlates