Sahar Shaker Sheta
Cairo University Children's Hospital, Egypt
Title: Real time three dimensional echocardiography in valvular pulmonary stenosis among pediatric age group
Biography
Biography: Sahar Shaker Sheta
Abstract
Background: Two Dimensional transthoracic echocardiography ( 2D –TTE) has been standard diagnostic imaging in patients with pulmonary valve stenosis ( PVS) .Recent advances has been the development of real time three dimensional transthoracic echocardiography (RT 3D-TTE) matrix-array transducers. Right ventricular outflow tract and pulmonary valve was not studied before by RT 3-D TTE among children. Objective: To determine the feasibility of RT 3D-TTE in the evaluation of PVS and measurement of pulmonary valve annulus (PVA), assess its reliability, reproducibility when compared with the standard 2D-TTE and invasive transcatheter angiography measurement. Methods: Prospective clinical study included 30 pediatric patients with mean age 2.76 years diagnosed with pulmonary valve stenosis were assessed by 2D-TTE, 3D-TTE and transcatheter angiography. Results: Transcatheter angiography sizing of (PVA) diameter had higher Pearson's correlation coefficient with RT 3-D TTE measurements (r = 0.909 & 0.812 respectively) than for 2-D TTE (r = 0.752). Measurements of PVA by the three techniques were compared with the reference standard by means of a Bland–Altman plot. Smallest mean absolute difference was obtained between (PVA) measurement trans catheter angiography (0.01(-0.07) cm) and RT 3D TTE diameter (0.01(-0.09) cm) rather than 2D TTE (0.11 (-0.06)cm). Interobserver reproducibility was calculated by means of intraclass correlation coefficient (ICC) of 2D-TEE was 0.983 (CI 95% 0.969 - 0.991; P < 0.001). Similarly, the value obtained with 3D-TTE was 0.981 (CI 95% 0.965–0.990; P < 0.001). Conclusion: RT 3D-TTE assessment of PVA is a feasible, reliable and reproducible imaging among children with PVS.