Noninvasive diagnosis of neonatal coarctation and associated anomalies using two-dimensional echocardiography.

Two-dimensional echocardiography (2DE) was used to study 51 neonates in whom coarctation of the aorta had been diagnosed clinically. In 40 patients, studies showed coarctation or arch interruption that was later confirmed at angiography, surgery, or autopsy. Of the remaining 11 studies, one gave a false positive result, one was technically poor, three had echocardiographic evidence of only mild arch narrowing and are being followed clinically, and six were negative. There were two false negative studies. Four studies were apparently true negatives. Many additional lesions were correctly identified by echocardiography although some, such as patent ductus arteriosus and small ventricular septal defect, were frequently missed. Twelve patients underwent surgery without preoperative catheterization. 2DE has proven extremely useful in confirming the diagnosis of neonatal coarctation of the aorta and sometimes obviates the need for invasive catheterization.