Real-time cross-sectional echocardiographic diagnosis of coarctation of the aorta. A prospective study of echocardiographic angiographic correlations

Real-time cross-sectional echocardiographic sector scan examinations were performed from a suprasternal notch location to image aortic arch anatomy in 15 children (ages 1 day to 21 yr) who were subsequently shown at cardiac catheterization to have coarctation of the descending thoracic aorta. The resulting echocardiographic images of the ascending, transverse and descending aorta imaged juxtaductal coarctation in all 15 patients. Echocardiography predicted discrete coarctation of the aorta in eight, isthmic hypoplasia in two, hourglass type coarctation deformities in three and longer segment coarctation in four patients. Catheterization and angiography confirmed all of these anatomic observations. The control group, 100 patients with congenital heart disease but without angiographic coarctations, included four patients with right-sided aortic arch and six patients with dextrocardia. The ascending, transverse and descending aorta were adequately imaged in 94 of these and no descending aortic abnormalities were noted. This study shows the potential utility of cross-sectional echocardiography for the noninvasive precatheterization or preoperative assessment of coarctation of the aorta in children and critically ill newborns.