J Korean Soc Echocardiogr.  1994 Jul;2(1):61-66. 10.4250/jkse.1994.2.1.61.

Doppler Echocardiography in the Diagnosis and the Estimation of the Severity of the Infundibular Pulmonic Stenosis

• Lee KN
• Son KH
• Kang HS
• Choue CW
• Kim KS
• Kim MS
• Song JS
• Bae JH

• KMID: 2410460
• DOI: http://doi.org/10.4250/jkse.1994.2.1.61

Abstract

BACKGROUND
The diagnosis and estimation of severity of infundibular pulmonic stenosis (PS) is difficult by two-dimensional or M-mode echocardiography. In continuous wave(CW) Doppler signal valvular PS is seen as a parabolic velocity profile but infundibular PS is seen as a velocity signal with its peak in late systole. The purpose of this study is that Doppler echocardiography can discriminate valvular PS from infundibular PS and assess the severity of infundibular obstruction. METHOD: Six patients with valvular and infundibular PS by Doppler echocardiography and cardiac catheterization were studied. All had been undergone surgery. We compared their Doppler echocardiographic and cardiac catheterization finding with surgical finding. RESULT: 1) CW Doppler signal of infundibular PS had lesser peak velocity(2.84m/sec vs 4.33m/sec, p < 0.05) and later systolic peak in velocity(AT/ET ratio : 0.73 vs 0.51, p < 0.05) than that of valvular PS. 2) Pressure gradient across the infundibular obstruction measured by Doppler echocardiography correlated well with that by cardiac catheterization(r=0.89, p < 0.05). 3) Operation finding showed infundibular PS in 5 case but not one and coexisting other anomaly such as ASD in 4 case, TOF in 1 case, PAPVR in 1 case.
CONCLUSION
Doppler echocardiography is a useful noninvasive method for the diagnosis and the estimation of severity of infundibular obstruction in patient with PS.

Keyword

Doppler echocardiography; Infundibular pulmonic stenosis; Valvular PS

MeSH Terms

Cardiac Catheterization
Cardiac Catheters
Diagnosis*
Echocardiography
Echocardiography, Doppler*
Humans
Methods
Pulmonary Valve Stenosis*
Systole

Figure

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  Fig. 1. Continuous wave Doppler signal of valvular and infundibular pulmonic stenosis. Left signal shows a parabolic flow velocity signal of valvular PS superimposed by infundibular PS in which a peak velocity occurs in late systole. Right signal shows only infundibular PS. AT: Acceleration time, ET: Ejection time

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  Fig. 2. Cardiac catheterization reveals infundibular pressure in same patient that Doppler finding was seen in Fig. 1. PA: pulmonary artery, INF: infundibulum. RV: right ventricle

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  Fig. 3. Comparison of infundibular pressure gradient by doppler echocardiography and catheterization.

Reference

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