Are routine preoperative cardiac catheterization and angiography necessary before repair of ostium primum atrial septal defect?

Steven E Lipshultz, Stephen P. Sanders, John E. Mayer, Steven D. Colan, James E. Lock

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Two-dimensional and Doppler echocardiography were compared with cardiac Catheterization and angiography in the preoperative evaluation of ostium primum atrial septal defect. Preoperative echocardiographic examinations as well as operative reports of all patients (33 patients aged 2 months to 23 years at surgery) with ostium primum atrial septal defect or transitional atrioventricular (AV) canal defect having had echocardiography and surgical repair at The Children's Hospital, Boston from July 1983 to January 1986 were retrospectively reviewed. Original cardiac Catheterization and angiographic reports also were reviewed. Preoperative echocardiography resulted in no false positive or false negative primary diagnoses when compared with the diagnoses obtained at preoperative angiography or surgery. Doppler assessment of mitral regurgitation correlated well with angiographic (93% agreement) and intraoperative (85% agreement) assessments of mitral regurgitation to within two diagnostic categories on the six level scoring system used. There was reasonably good agreement between the two-dimensional ecbocardiographic estimate of right ventricular systolic pressure and that measured at Catheterization when expressed as percent of the simultaneous left ventricular pressure. Seven of nine ventricular septal defects observed intraoperatively were noted on preoperative echocardiography; five of these defects were detected on preoperative angiography. A variety of other surgically confirmed associated cardiovascular defects were observed by both preoperative techniques. However, echocardiography appeared to be superior to angiography for evaluation of AV valve morphology and papillary muscle architecture. This study implies that in children with typical clinical and two-dimensional echocardiographic and Doppler findings for ostium primum atrial septal defect or transitional AV canal defect, routine preoperative cardiac Catheterization and angiography are unnecessary.

Original languageEnglish
Pages (from-to)373-378
Number of pages6
JournalJournal of the American College of Cardiology
Volume11
Issue number2
DOIs
StatePublished - Jan 1 1988
Externally publishedYes

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Cardiac Catheterization
Angiography
Echocardiography
Mitral Valve Insufficiency
Ventricular Pressure
Papillary Muscles
Doppler Echocardiography
Ventricular Heart Septal Defects
Catheterization
Atrial Septal Defect Ostium Primum
Blood Pressure
Atrioventricular Septal Defect

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Are routine preoperative cardiac catheterization and angiography necessary before repair of ostium primum atrial septal defect? / Lipshultz, Steven E; Sanders, Stephen P.; Mayer, John E.; Colan, Steven D.; Lock, James E.

In: Journal of the American College of Cardiology, Vol. 11, No. 2, 01.01.1988, p. 373-378.

Research output: Contribution to journalArticle

Lipshultz, Steven E ; Sanders, Stephen P. ; Mayer, John E. ; Colan, Steven D. ; Lock, James E. / Are routine preoperative cardiac catheterization and angiography necessary before repair of ostium primum atrial septal defect?. In: Journal of the American College of Cardiology. 1988 ; Vol. 11, No. 2. pp. 373-378.
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