Utility of Doppler Echocardiography in the Evaluation of Aortic Homograft Valved Conduit Function in Children: Need for Segmental Conduit Interrogation

Abstract

To assess the utility of Doppler echocardiography in evaluation of aortic homograft valved conduit function, 10 consecutive pediatric patients had Doppler examination of aortic homograft valved conduits associated with follow‐up cardiac catheterization. General correlation was found between the Doppler‐derived peak systolic pressure gradient across the aortic homograft valved conduit and cardiac catheterization (r = 0.65, P < 0.05, SEE = 20.5). One patient with multilevel obstruction had significant underestimation of gradient by Doppler due to incomplete segmental interrogation of the aortic homograft valved conduit. For the other nine patients with complete segmental conduit interrogation, correlation between Doppler and cardiac catheterization was excellent (r = 0.93, P < 0.01, SEE = 10). Conduit insufficiency in nine out of ten patients was graded qualitatively using Doppler color flow mapping with excellent correlation between color flow mapping and cardiac catheterization (rS= 0.98) Aortic homograft valved conduit function can be accurately noninvasively assessed by Doppler but proximal, valve, and distal conduit segmental interrogation is necessary to localize site of obstruction if present, rule out multilevel obstruction, and avoid underestimation of systolic gradient.