Intraoperative two-dimensional Doppler echocardiography. A preliminary study for congenital heart disease.

Intraoperative two-dimensional echocardiograms were performed in 30 patients (group I) and two-dimensional Doppler color flow imaging was performed in 30 additional patients (group II) with various forms of congenital heart disease. A comparative complete two-dimensional Doppler and color flow examination was performed in group II patients 10 to 14 days postoperatively. Standard intraoperative two-dimensional echocardiograms demonstrated excellent correlation with preoperative findings and allowed assessment of valvular regurgitation or shunt when combined with echocardiographic contrast injections. However, intraoperative and postoperative two-dimensional color flow imaging was obtained more easily and rapidly and allowed recognition of more postoperative residual defects. Color flow imaging appears to be a useful method for intraoperative assessment of surgical repair of congenital cardiac defects. Twenty-one residual lesions were correctly diagnosed intraoperatively, whereas seven residual lesions were demonstrated only during later postoperative examination. This preliminary experience has also demonstrated several areas for future development and improvement of these techniques. Combined two-dimensional Doppler and contrast echocardiographic studies may allow better disclosure of residual defects.