Guiding roles of echocardiography and angiocardiography in interventional treatment of congenital heart disease in children

Luo Pei; Li Cheng; Wang Jinliang; Fang Xiang

doi:10.3760/j.issn.1673-4777.2019.11.009

Abstract：Objective To investigate the guiding roles of echocardiography and angiocardiography(ACG)in interventional treatment of congenital heart disease(CHD) in children.Methods A total of 108 children with CHD admitted to People's Hospital of Deyang City,Sichuan Province from January 2010 to December 2018 were enrolled,including 38 cases of ventricular septal defect (VSD),52 cases of patent ductus arteriosus (PDA) and 18 cases of pulmonary artery stenosis (PS).All children underwent transthoracic echocardiography (TTE) and ACG;transcatheter closure guided by TTE or ACG was performed as appropriate.Diagnostic rate,measurements of lesion diameter and the therapeutic effect of operation with TTE or ACG guidance were analyzed.Results Preoperative diagnostic rates of TTE and ACG for VSD,PDA and PS were 100％.Among 104 children who met the indication of interventional treatment,measurement of lesion diameter of TTE in children with PDA (n =50) was significantly higher than that of ACG [(4.0 ± 1.3) mm vs (3.3 ± 1.0) mm] (t =2.75,P ＜ 0.01).There was no significant difference of measurement of lesion diameter between TTE and ACG in children with VSD and PS (n =36,18) (P ＞0.05).The success rate of TTE-guided procedure was 93.3％ (28/30) and that of ACG was 96.0％ (71/74),showing no significant difference between them (x2 =0.732,P =0.184).There was no evidence that the failure of interventional procedure was related with the choice of imaging guidance.Thirteen of 99 children with successful closure showed small shunts in postoperative angiography and all shunts disappeared in 24 hours.Conclusion TTE and ACG have different advantages for different types of CHD intervention;it is necessary to combine both modalities to achieve optimisic diagnostic and therapeutic results.