Complete Follow‐Up Echocardiograms are Needed to Detect Stenosis of Normally Connecting Pulmonary Veins

摘要: Reimbursement for limited echocardiograms focusing on known pathology rather than complete studies has recently received widespread attention. Few data are available to determine if these examinations provide enough information adequately evaluate many forms of congenital heart disease. Stenosis normally connecting pulmonary veins is a or acquired cardiac anomaly that difficult diagnose clinically and may be detectable only by echocardiography. To the yield versus detecting presence development stenosis in with anatomically normal connections, cardiology database was searched all patients this diagnosis presenting between June 1990 January 2000. Charts were reviewed demographic data, associated defects, surgeries, outcomes. Angiograms location severity vein stenosis. A pulsed-wave Doppler signal > 1.6 mm/sec loss phasic flow used define Eighteen identified ranged age at first evaluation from 1 day 17 years (median 15 days). All 18 had anomalies, 4 (22%) Trisomy 21. Pulmonary detected initial 5 patients, 8 +/- months after echocardiogram 11 missed echocardiography 2 who diagnosed catheterization. The complete, pulsed-Doppler sampling four patients. Of 12 echocardiographic evidence late stenosis, 10 interim prior eventually having diagnostic follow-up study. two whom echocardiography, one study technically inadequate (17-year-old) echocardiogram. 9 repair attempted, 3 no residual obstruction 6 progressive (three deaths). remaining nine intervention their venous have died hypertension. an uncommon lesion significant impact clinical outcome. stenoses might undetectable focus evaluating specified pathology. Complete warranted lesion. This important consideration when formulating reimbursement policies.