Accuracy of echocardiography in diagnosing total anomalous pulmonary venous return. | [Pakistan Journal of Medical Sciences • 2018]

Author(s):

1. Sonia Qureshi: Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan

2. Muneer Amanullah: FRCS (General Surgery RCS Edinburgh). Department of Surgery, Karachi,Pakistan

3. Mehnaz Atiq: Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan.

4. Fatima Ali: Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan

Abstract:

Total anomalous pulmonary venous return is an uncommon cyanotic congenital heart defect. Echocardiography is the initial diagnostic tool. Complimentary non-invasive modalities like cardiac computerized tomographic angiography and cardiac magnetic resonance imaging have replaced the need for cardiac catheterization in difficult cases. This study aimed to determine the accuracy of echocardiography in diagnosing total anomalous pulmonary venous return, and to determine the factors that may decrease its sensitivity. Methods: This was a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan from January 2010 to August 2016. All patients who were diagnosed with Total anomalous pulmonary venous return on echocardiography and had subsequent confirmation either on cardiac CT angiography or surgery were included. The diagnostic accuracy of echocardiography was expressed as sensitivity. Previously described taxonomy was used to define diagnostic error. Univariate and multivariate analysis were done by logistic regression OR (95% CI) were reported to identify factors causing the diagnostic error. Results: High diagnostic sensitivity (81%) was found in isolated total anomalous pulmonary venous return and low (27%) in heterotaxy and mixed (20%) varieties. Poor acoustic windows and right isomerism were found to be significant factors responsible for the diagnostic error on multivariate analysis. Conclusion: Echocardiography can diagnose isolated total anomalous pulmonary venous return with high accuracy. Use of additional modalities may be required for a complete diagnosis in cases with mixed variety, heterotaxy and poor acoustic windows.

Page(s): 1094-1098

DOI: DOI not available

Published: Journal: Pakistan Journal of Medical Sciences, Volume: 34, Issue: 5, Year: 2018

Keywords:

Accuracy of echocardiography in diagnosing total anomalous pulmonary venous return

References:

References are not available for this document.

Citations

Citations are not available for this document.

Citations

Downloads

Views