Article Text
Abstract
Aims Objective of this study was to evaluate the feasibility of the non-invasive dye dilution method to quantify shunt size related to atrial septal defects (ASD).
The diagnostic accuracy of shunt size determination in ASD’s has been suboptimal with common non-invasive methods. We have previously developed a cost-effective and time-effective non-invasive dye dilution method. In this method, the indocyanine green solution is injected into the antecubital vein and the appearance of the dye is detected with an earpiece densitometer.
Methods and results We studied 192 patients with an ASD. Mean pulmonary blood flow/systemic blood flow (Qp/Qs) was measured with dye dilution technique and compared with following methods: Fick’s invasive oximetry (n=49), transoesophageal echocardiography (TEE) measuring ASD size (n=143) and cardiac MR (CMR) (n=9).
For the first 49 patients, Qp/Qs was 2.05±0.70 with the Fick’s invasive oximetry and 2.12±0.68 with dye dilution method with an excellent correlation between the two methods (R=0.902, p<0.001). In the second study sample, the ASD size by TEE was 15±6 mm on average, and the mean Qp/Qs 2.16±0.65 measured with dye dilution method with a good correlation between the methods (R=0.674, p<0.001). Qp/Qs measured with CMR was 1.87±0.40 resulting in a good correlation with the dye dilution method (R=0.696, p=0.037).
Conclusion The dye dilution method with earpiece densitometer recording is a clinically feasible and reliable method to assess shunt size in ASDs.
- congenital heart disease
- stroke
- MRI
- transoesophageal
- minimally invasive
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Footnotes
Twitter @VMuroke
Contributors VM: corresponding author, planning, data collection, analysis, writing and editing. MJ: data analysis, writing and figure editing. PS: data collection, writing and editing. MH: MRI data collection, writing and editing. MV: invasive oximetry data collection, methods section writing and editing. JS: main editor and supervisor of the work. All the authors have seen and approved the final manuscript and are fully conversant with its contents.
Funding This study was supported by The Finnish Medical Foundation.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study complies with the Declaration of Helsinki. The study protocol was reviewed and approved by the institutional review board of Heart and Lung Center, Helsinki University Hospital (HUS/26/2018).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All the data are stored in a Helsinki University Central Hospital protected disc drive and are available on reasonable request.