Dextrose 5% contrast echocardiography for diagnosis of unroofed coronary sinus in a child with tetralogy of Fallot: Novel use of an old solution

摘要

Unroofed coronary sinus (UCS) is a rare congenital heart disease. Contrast echocardiography is an established non-invasive tool for diagnosis of UCS. Association of tetralogy of Fallot (TOF) and UCS is very rare. This is the report of a four-year-old girl with TOF and UCS with bilateral superior vena cava diagnosed by contrast echocardiography using both agitated saline and agitated dextrose water 5% (DW5%). DW5%-contrast echocardiography was as effective as saline contrast echocardiography regarding the size, echogenicity and stability of the microbubbles. The advantages and disadvantages of the currently available ultrasound-enhancing agents (UEA) in terms of safety, adverse effects, contraindications and worldwide availability are compared. In contrast to saline, DW5% does not cause volume expansion. In contrary to Lumason, Optison and Definity, it is available worldwide at a relatively low-cost with no adverse effect. Dextrose 5% is a safe and effective UEA for pediatric contrast echocardiography in children with congenital heart disease.