Are routine preoperative cardiac catheterization and angiography necessary before repair of ostium primum XXXX ?

@entity1 @entity339 @entity1757 @entity118 @entity65
Two-dimensional and Doppler echocardiography were compared with cardiac catheterization and angiography in the preoperative evaluation of ostium primum @entity118 . Preoperative echocardiographic examinations as well as operative reports of all @entity1 (33 @entity1 aged 2 months to 23 years at surgery) with ostium primum @entity118 or transitional atrioventricular (AV) canal defect having had echocardiography and surgical repair at The @entity1 's Hospital, Boston from July 1983 to January 1986 were retrospectively reviewed. Original cardiac catheterization and angiographic reports also were reviewed. Preoperative echocardiography resulted in no false positive or false negative primary diagnoses when compared with the diagnoses obtained at preoperative angiography or surgery. Doppler assessment of @entity339 correlated well with angiographic (93% agreement) and intraoperative (85% agreement) assessments of @entity339 to within two diagnostic categories on the six level scoring system used. There was reasonably good agreement between the two-dimensional echocardiographic estimate of right ventricular systolic pressure and that measured at catheterization when expressed as percent of the simultaneous left ventricular pressure. Seven of nine @entity1757 observed intraoperatively were noted on preoperative echocardiography; five of these defects were detected on preoperative angiography. A variety of other surgically confirmed associated @entity65 were observed by both preoperative techniques. However, echocardiography appeared to be superior to angiography for evaluation of AV valve morphology and papillary muscle architecture. This study implies that in @entity1 with typical clinical and two-dimensional echocardiographic and Doppler findings for ostium primum @entity118 or transitional AV canal defect, routine preoperative cardiac catheterization and angiography are unnecessary.
