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Hand‐held echocardiography in children with hypoplastic left heart syndrome

Alan F. Riley1, Elena C. Ocampo1, Joseph Hagan2, M. Regina Lantin‐Hermoso1

1 Section of Pediatric Cardiology, Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas
2 Newborn Center, Texas Children's Hospital, Houston, Texas

* Corresponding Author: Alan F. Riley, MD, Section of Pediatric Cardiology, Department of Pediatrics, Texas Children’s Hospital, 6621 Fannin Street, MC 19345‐C, Houston, TX 77030. Email: email

Congenital Heart Disease 2019, 14(5), 706-712. https://doi.org/10.1111/chd.12774

Abstract

Background: When performed by cardiologists, hand‐held echocardiography (HHE) can assess ventricular systolic function and valve disease in adults, but its accuracy and utility in congenital heart disease is unknown. In hypoplastic left heart syndrome (HLHS), the echocardiographic detection of depressed right ventricular (RV) systolic function and higher grade tricuspid regurgitation (TR) can identify patients who are at increased risk of morbidity and mortality and who may benefit from additional imaging or medical therapies.
Methods: Children with HLHS after Stage I or II surgical palliation (Norwood or Glenn procedures) were prospectively enrolled. Subjects underwent HHE by a pediatric cardiologist on the same day as standard echocardiography (SE). Using 4‐point scales, bedside HHE assessment of RV systolic function and TR were compared with blinded assessment of offline SE images. Concordance correlation coefficient (CCC) was used to evaluate agreement.
Results: Thirty‐two HHEs were performed on 15 subjects (Stage I: n = 17 and Stage II: n = 15). Median subject age was 3.4 months (14 days‐4.2 years). Median weight was 5.9 kg (2.6‐15.4 kg). Bedside HHE assessment of RV systolic function and TR severity had substantial agreement with SE (CCC = 0.80, CCC = 0.74, respectively; P < .001). HHE sensitivity and specificity for any grade of depressed RV systolic function were 100% and 92%, respectively, and were 94% and 88% for moderate or greater TR, respectively. Average HHE scan time was 238 seconds.
Conclusions: HHE offers a rapid, bedside tool for pediatric cardiologists to detect RV systolic dysfunction and hemodynamically significant TR in HLHS.

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Cite This Article

APA Style
Riley, A.F., Ocampo, E.C., Hagan, J., Lantin‐Hermoso, M.R. (2019). Hand‐held echocardiography in children with hypoplastic left heart syndrome. Congenital Heart Disease, 14(5), 706-712. https://doi.org/10.1111/chd.12774
Vancouver Style
Riley AF, Ocampo EC, Hagan J, Lantin‐Hermoso MR. Hand‐held echocardiography in children with hypoplastic left heart syndrome. Congeni Heart Dis. 2019;14(5):706-712 https://doi.org/10.1111/chd.12774
IEEE Style
A.F. Riley, E.C. Ocampo, J. Hagan, and M.R. Lantin‐Hermoso, “Hand‐held echocardiography in children with hypoplastic left heart syndrome,” Congeni. Heart Dis., vol. 14, no. 5, pp. 706-712, 2019. https://doi.org/10.1111/chd.12774



cc Copyright © 2019 The Author(s). Published by Tech Science Press.
This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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