ABSTRACT
Objective To evaluate the value of echocardiography in diagnosing infective endocarditis (IE) in children. Methods The shape, size, echogenicity, distribution of vegetations and valvular function of the heart were observed by transthoracic echocardiography (TTE) in 30 patients with suspected IE. We correlated TTE ifndings with the results of hemoculture and serologic test. Results Vegetations were observed in all patients by echocardiography:seven patients with tricuspid valve vegetations, two with mitral valve vegetations, three with pulmonary valve vegetations, three with main pulmonary artery vegetations, three with aortic valve vegetations, two with aortic valve abscess, and two with vegetations in right atrium. After anti-infection therapy, the size of vegetations in iffteen patients became smaller and the less echogenic than before. Vegetations disappeared in two patients. Vegetation was recurrent repeatedly in one case. Ten patients recovered after operation. Two severe cases died. Five patients underwent TTE again one week after the previous negative TTE. Of them, echocardiography demonstrated vegetations in three cases. However, no vegetations were found in rest two cases because antibiotics had been used at early stage. In addition, echocardiography demonstrated one patient with mitral valve vegetation. But the lesion was ifnally conifrmed to be operating suture. The sensitivity and specificity of TTE in detecting vegetations were 88.0% and 80.0%, respectively. Blood cultures were positive in twenty-seven cases and were negative in three cases. Conclusions The early diagnosis of IE is important to improve patient′s prognosis. It takes a long time in organism cultivation before achieving the clinical diagnosis. TTE can help obtain an early diagnosis stage of IE, and provide the assessment of size and location of vegetation. It plays an important role in treatment and prognosis prediction.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical value of 3D visualization method for simulating percutaneous transcatheter closure of atrial septal defect (ASD).</p><p><b>METHODS</b>3D volume render method was used for visualizing ASD and surrounding structures and 3D modeling method was applied for simulate the shape of occlusion device. The size and the distance between the lower edge of device and atria-ventricular valve of simulation occluder and actual selected atrial septal occluder (ASO) were compared in 30 patients underwent successful transcatheter closure of ASD.</p><p><b>RESULTS</b>The location, geometry, size, extent of ASDs in children were displayed in 3D visualization. No significant difference was found between simulation occluder and ASO size measured from left atrium [(26.07 +/- 5.32) cm vs. (25.91 +/- 5.32) cm] and right atrium [(22.13 +/- 5.31) cm vs. (22.08 +/- 5.26) cm, all P > 0.05]. The distances from simulation occluder to mitral valves [(5.76 +/- 2.39) cm] and to tricuspid valves [(8.25 +/- 2.40) cm] were similar as ASO to atria-ventricular valves [(5.61 +/- 2.26) cm and (8.02 +/- 2.48) cm, respectively, all P > 0.05].</p><p><b>CONCLUSIONS</b>The simulating percutaneous transcatheter closure of ASD by 3D visualization technique could be a helpful noninvasive approach for ASO selection before the procedure of transcatheter occlusion of ASD.</p>