Echocardiographic Pattern of Right Ventricular Diastolic Volume Overload in Children

Abstract

Echocardiograms were performed on 20 children who were 1-14 years old. Ten children had secundum atrial septal defects (ASD 2°); four had partial and two had complete atrioventricular canal defects (AVC); and three had partial and one had total anomalous pulmonary venous connection (APVC). Twenty-eight normal children were also examined. Echocardiograms of nine patients with ASD 2° revealed increased right ventricular dimension index (RVDI) and abnormal (paradoxic) ventricular septal (VS) motion. The remaining patient with ASD 2°, who had a Qp/Qs of 1.2 (smallest in the series), had a normal echocardiogram. All four patients with APVC had increased RVDI, and three had abnormal VS motion. The patient with normal septal motion had associated mild aortic stenosis, but he too had a small left-to-right shunt (19%). The echocardiograms of two patients with partial AVC revealed features similar to ASD 2°, but in the third patient who had significant mitral regurgitation (MR) the VS motion was normal, indicating that the degree of associated MR influences the VS motion in this anomaly. The septal motion was normal in both patients with complete AVC. Three patients in the series had abnormal systolic anterior motion of mitral valve. Postoperative echocardiograms revealed persistence of increased RVDI and "paradoxic" VS motion.