Initial experience and indications for intracardiac/intravascular ultrasound

Intracardiac/intravascular ultrasound (ICVUS) is a diagnostic tool that has not been fully utilized in its capability to assess pathology in patients with congenital heart disease (CHD) or those without. From 10/92 - 12/96, 79 ICVUS were performed in 74 children with CHD and 5 adults during interventional or hemodynamic cardiac catheterization (CC). Age range was 3 months to 62 years. Equipment and imaging parameters are shown in the table. 2.8 Fr 4.8 Fr 6.2 Fr 6 Fr 8 Fr 30 20 12.5 20 15 mHz mHz mHz mHz mHz Aloka (n=65) 1 34 30 Hewlett-Packard (n=6) 2 4 Diasonics (n=3) 2 1 In the 49 children, ICVUS was performed during interventional CC for balloon dilation of coarctation of the aorta (20), pulmonary valve stenosis (15), peripheral pulmonary artery stenosis (4), aortic stenosis (2) and placement of stents (6) and patent ductus coils (2). In 25 children, ICVUS was performed to evaluate for conduit obstruction (14), thrombus (9), P/O anomalous coronary artery (1) and sinus venous atrial septal detect (1). In 5 adults, ICVUS was used to assess femoral artery dissection/stent placement (1), mesenteric artery thrombus/ dissection (1), thrombus (2) and inferior vena cava filter placement (1). In CHD children, ICVUS was most useful in assessing artery dilation, stent placement, conduit obstruction, and thrombus detection In adult patients, ICVUS influenced diagnosis and device placement when other imaging techniques were inadequate. Conclusion: ICVUS is a valuable tool in assessing different types of cardiac/vascular pathology, especially after interventional CC procedures, fo conduit obstruction and thrombus detection in CHD children; and in adults to assess for dissection, thrombus, and guide device placement.