Role of Three Dimensional Echocardiography in Assessment of Aortic Valve Annulus in Children with Congenital Aortic Stenosis Prior to Balloon Aortic Valvuloplasty Compared to Two Dimensional Echocardiography and Angiography

Abstract

SUMMARY T his study was performed in Ain Shams University hospitals on 31 patients subdivided into 2 groups; normal and diseased AV morphology, referred for cardiac catheterization or follow up echocardiography where all patients were subjected to adequate history taking, proper physical examination, 2D echocardiography, 3D echocardiography and angiography to visualize the aortic annulus. Group I included 11 males (64.7 %) and 6 females (35.3 %), with a mean age of 5.76 ± 6.39 years (range 1 month to 27 years). All of these patient had aortic valve disease with a bicuspid variant in all 17 patients. Group II included 7 males (50 %) and 7 females (50 %), with a mean age of 4.4 ± 4.05 years (range 1 – 16 years). All of these patient had normal aortic valve morphology in addition to another congenital cardiac anomaly. The aortic valve annulus was assessed using the three modalities; 2D,3D echocardiography in the vertical and horizontal diamteres, and angiography. AVA was measured by 2D and 3D echocardiography using MPR mode. The study concluded that that 3D echocardiogarphic measurement of the aortic annulus (horizontal diameter) correlated better with angiography than 2D and 3D (vertical diameter) echocardiographic measurements.