Serial echocardiographic profiles in infants and children with goarctation of the aorta

Eighty-three serial M mode echocardiograms were obtained from 13 medically managed infants and children aged 1 day to 3 1 2 years with coarctation documented at cardiac catheterization. Associated lesions included ventricular septal defect (two patients), atrial septal defect (two patients) and mild aortic stenosis (six patients). The echocardiograms were separated into four groups according to the patient's age: Group A, nine infants aged 1 day to 6 weeks; group B, nine infants aged 6 weeks to 4 months; group C, seven infants aged 4 months to 1 year; and group D, four children aged 1 to 3 1 2 years. Left ventricular diastolic dimension was significantly decreased in group A but gradually increased to normal with age. Right ventricular cavity dimension was significantly greater than normal in groups A and B and decreased toward normal with age. Right ventricular wall thickness was significantly increased initially and remained so. Septal and left ventricular posterior wall thickness measurements were not significantly different from normal in group A but increased progressively with age. Mean velocity of circumferential fiber shortening, corrected for heart rate, was significantly depressed in the youngest infants, despite digoxin therapy, but was normal thereafter. This study documents slight regression of right ventricular enlargement, left ventricular growth and hypertrophy and improvement in left ventricular function in growing infants and children with coarctation of the aorta. Echocardiography is useful in assessment of ventricular development in neonates with coarctation and in serial follow-up studies of cardiac adaptation to this lesion.