Echocardiography in Pediatric and Adult Congenital Heart Disease

Edited by expert clinicians at Mayo Clinic and other leading global institutions, Echocardiography in Pediatric and Adult Congenital Heart Disease remains your reference of choice in this fast-changing field. The Third Edition brings you fully up to date not only with all aspects of pediatric echocardiography, but also with multimodality imaging in adult congenital heart disease, making it an invaluable resource for cardiologists, fellows, internists, and radiologists, as well as pediatric echocardiographers and sonographers.

• Covers the full range of congenital and acquired heart abnormalities as well as valve prostheses and the transplanted heart, providing state-of-the-art knowledge to assess challenging cardiac lesions and physiology.
• Places increased emphasis on multimodality imaging (MR/CT), equipping you to better meet the inherent challenges of echo imaging for adults with repaired congenital heart disease.
• Includes board-style questions and answers for every chapter—perfect for exam review and self-assessment.
• Helps you obtain the maximum diagnostic value from today’s imaging approaches: tissue Doppler, 3D echo, intra-cardiac and intraoperative transesophageal echo, and cardiac MRI and MR angiography.
• Depicts the full range of echo findings with more than 800 illustrations (most in full-color), more correlative anatomic images, numerous tables, and over 200 videos online.

Enrich Your eBook Reading Experience

• Read directly on your preferred device(s), such as computer, tablet, or smartphone.
• Easily convert to audiobook, powering your content with natural language text-to-speech.

Table of Contents:

1. Cover
2. Title Page
3. Copyright
4. Dedication
5. Contributors
6. Preface
7. Acknowledgements
8. Contents
9. 1 Principles of Cardiovascular Ultrasound
10. INTRODUCTION
11. WHAT IS ULTRASOUND?
12. SOME DEFINITIONS
13. IMAGE GENERATION
14. COMMON IMAGING FORMATS AND IMAGING ARTIFACTS
15. THE DOPPLER EFFECT AND CARDIOVASCULAR HEMODYNAMICS
16. THE DOPPLER EQUATION
17. RELATIONSHIP BETWEEN VELOCITY AND PRESSURE DIFFERENCES
18. DOPPLER ECHOCARDIOGRAPHIC MODALITIES
19. ACKNOWLEDGMENT
20. SUGGESTED READING
21. Chapter 1: Multiple Choice Question
22. 2 Practical Issues Related to the Examination, Anatomic Image Orientation, and Segmental Cardiovascular Analysis
23. INTRODUCTION
24. GENERAL EXAMINATION GUIDELINES
25. IMAGE ACQUISITION
26. Approach to Abnormal Cardiac Positions/Complex Anatomy
27. Transesophageal Imaging
28. THE ECHOCARDIOGRAPHIC REPORT
29. IMAGE ORIENTATION AND NOMENCLATURE IN CONGENITAL HEART DISEASE
30. NOMENCLATURE OF CONGENITAL HEART DISEASE
31. Situs or Sidedness
32. Visceral Situs or Sidedness
33. Atrial Situs or Sidedness
34. TERMS USED TO DESCRIBE CARDIOVASCULAR SEGMENTS AND CONNECTIONS
35. Some Synonyms
36. SEQUENTIAL SEGMENTAL ANALYSIS OF CARDIOVASCULAR ANATOMY AND CONGENITAL CARDIAC MALFORMATIONS
37. DETERMINATION OF CARDIAC LOCATION AND SITUS (SIDEDNESS)
38. Abdominal Situs
39. Atrial Situs
40. SEGMENTS AND CONNECTIONS
41. The Venous Segment
42. The Atrial Segment
43. The Atrioventricular Connection
44. The Ventricular Segment
45. The Ventricular–Great Arterial Connection
46. The Great Arterial Segment
47. ACKNOWLEDGMENT
48. REFERENCES
49. SUGGESTED READING
50. Chapter 2: Multiple Choice Question
51. 3 Quantitative Methods in Echocardiography—Basic Techniques
52. Introduction
53. ECHOCARDIOGRAPHIC ASSESSMENT OF GLOBAL SYSTOLIC VENTRICULAR FUNCTION
54. Left Ventricular Shortening Fraction
55. Left Ventricular Ejection Fraction
56. Left Ventricular Mass
57. VELOCITY OF CIRCUMFERENTIAL FIBER SHORTENING AND THE STRESS-VELOCITY INDEX
58. Doppler Parameters of Left Ventricular Systolic Function
59. Left Ventricular dP/dt
60. Myocardial Performance Index (Tei Index)
61. ECHOCARDIOGRAPHIC ASSESSMENT OF REGIONAL SYSTOLIC VENTRICULAR FUNCTION
62. Two-Dimensional Imaging
63. Tissue Doppler Imaging and Strain Rate Imaging
64. ECHOCARDIOGRAPHIC ASSESSMENT OF DIASTOLIC VENTRICULAR FUNCTION
65. Evaluation of Diastolic Ventricular Function—Technical Considerations
66. Mitral Inflow Doppler
67. Pulmonary Venous Doppler
68. Patterns of Diastolic Dysfunction
69. Clinical Utility of Diastology
70. Qualitative Versus Quantitative Diastology
71. Limitations and Pitfalls of Doppler Evaluation of Diastolic Ventricular Function
72. NEWER ECHOCARDIOGRAPHIC TECHNIQUES TO EVALUATE DIASTOLIC VENTRICULAR FUNCTION
73. Tissue Doppler Imaging
74. Tissue Doppler Studies in Normal Children
75. Color M-mode Flow Propagation Velocity
76. Left Atrial Volume
77. ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR FUNCTION
78. Tricuspid Annular Plane Systolic Excursion
79. Right Ventricular Myocardial Performance Index
80. Right Ventricular dP/dt
81. Right Ventricular Tissue Doppler Imaging
82. Acoustic Quantification and Right Ventricular Function
83. Three-Dimensional Echocardiography and Right Ventricular Function
84. Evaluation of Right Ventricular Diastolic Function
85. ECHOCARDIOGRAPHIC ASSESSMENT OF SINGLE VENTRICLE FUNCTION IN PATIENTS WITH COMPLEX CONGENITAL HEART DISEASE
86. SUGGESTED READING
87. Chapter 3: Multiple Choice Question
88. 4 Quantitative Methods in Echocardiography—Advanced Techniques in the Assessment of Ventricular Function
89. THREE-DIMENSIONAL ECHOCARDIOGRAPHY IN FUNCTIONAL ASSESSMENT
90. From Reconstruction Techniques to Real-Time Three-Dimensional Imaging
91. Technical Aspects
92. Imaging Protocols
93. Clinical Applications
94. Future Directions
95. TISSUE-DOPPLER IMAGING FOR THE EVALUATION OF MYOCARDIAL FUNCTION
96. Current Clinical Applications of Tissue Velocities
97. Use of Tissue-Doppler Velocities in Children
98. Deformation Imaging in Pediatric and Congenital Heart Disease
99. Normative Myocardial Deformation Data in Children
100. Clinical Applications of Myocardial Deformation Imaging in Pediatric Heart Disease
101. MAGNETIC RESONANCE IMAGING FOR THE ASSESSMENT OF VENTRICULAR FUNCTION
102. Cardiac Magnetic Resonance Techniques Used for the Assessment of Ventricular Function
103. Cardiac Magnetic Resonance to Assess Ventricular Function
104. Clinical Applications
105. Acquisition Protocols
106. Data Analysis
107. Problems and Potential Solutions
108. Future Applications
109. CONCLUSION
110. SUGGESTED READING
111. Chapter 4: Multiple Choice Question
112. 5 Cardiac Electromechanical Dyssynchrony in Patients With Congenital Heart Disease
113. INTRODUCTION
114. PATHOPHYSIOLOGY OF ELECTROMECHANICAL DYSSYNCHRONY AND BASIC PRINCIPLES OF CRT
115. CRT IN PEDIATRIC AND CONGENITAL HEART DISEASE
116. ATRIOVENTRICULAR, INTERVENTRICULAR, AND INTRAVENTRICULAR DYSSYNCHRONY
117. Atrioventricular Dyssynchrony
118. Interventricular Dyssynchrony
119. Intraventricular Dyssynchrony
120. CRT IN PATIENTS WITH A BIVENTRICULAR CIRCULATION AND SYSTEMIC LEFT VENTRICLE
121. The Failing Systemic Left Ventricle
122. The Failing Subpulmonary Right Ventricle
123. CRT IN PATIENTS WITH A BIVENTRICULAR CIRCULATION AND SYSTEMIC RIGHT VENTRICLE
124. CRT IN PATIENTS WITH A SINGLE VENTRICLE
125. PATIENT SELECTION FOR CRT IN CONGENITAL HEART DISEASE
126. SUGGESTED READING
127. 6 Anomalies of the Pulmonary and Systemic Venous Connections
128. ANOMALOUS PULMONARY VENOUS CONNECTIONS
129. Introduction, Nomenclature, and Embryogenesis
130. Transthoracic Imaging of Pulmonary Venous Connections
131. Total Anomalous Pulmonary Venous Connection
132. Fetal Imaging of TAPVC
133. Partial Anomalous Pulmonary Venous Connections
134. TEE Imaging of Normal Pulmonary Venous Connections
135. TEE Imaging of PAPVC
136. Postoperative Echocardiography in PAPVC
137. ANOMALOUS SYSTEMIC VENOUS CONNECTIONS
138. Introduction, Nomenclature, and Embryogenesis
139. SUGGESTED READING
140. Chapter 6: Multiple Choice Question
141. 7 Abnormalities of Atria and Atrial Septation
142. ATRIAL SEPTAL ANATOMY AND EMBRYOLOGY
143. ATRIAL SEPTAL DEFECT
144. Clinical Presentation
145. Physiology
146. Complications
147. EVALUATION OF ATRIAL SEPTAL DEFECT: OVERVIEW
148. Subcostal Imaging
149. Parasternal Views
150. Apical 4-Chamber View
151. Suprasternal Notch Views
152. Additional Imaging
153. TWO-DIMENSIONAL ECHO ANATOMY AND IMAGING
154. Patent Foramen Ovale
155. Secundum Atrial Septal Defect
156. Sinus Venosus Defect With Partial Anomalous Pulmonary Venous Connection
157. Coronary Sinus Atrial Septal Defect (Unroofed Coronary Sinus)
158. Associated Defects
159. Interventional and PostInterventional Imaging
160. COR TRIATRIATUM
161. Background
162. Clinical Presentation
163. Two-Dimensional Echo Anatomy and Imaging
164. Subcostal Views
165. Parasternal Views
166. Apical View
167. Suprasternal Notch Views
168. Postoperative Assessment of Cor Triatriatum
169. COR TRIATRIATUM DEXTER
170. SUGGESTED READING
171. Chapter 7: Multiple Choice Question
172. 8 Atrioventricular Septal Defects
173. INTRODUCTION
174. TERMINOLOGY AND CLASSIFICATION
175. ANATOMIC FEATURES OF AVSD
176. Level of Atrioventricular Valve Insertion
177. Elongate Left Ventricular Outflow Tract
178. Cleft Left Atrioventricular Valve
179. Counterclockwise Rotated Papillary Muscles
180. ECHOCARDIOGRAPHIC EVALUATION OF AVSD
181. Primum Atrial Septal Defect
182. Mitral Valve Abnormalities
183. Left Ventricular Outflow Tract Obstruction
184. UNBALANCED AVSD
185. RASTELLI CLASSIFICATION OF THE COMMON ATRIOVENTRICULAR VALVE
186. LESIONS ASSOCIATED WITH AVSD
187. DOWN SYNDROME AND AVSD
188. FETAL ECHO ASSESSMENT OF AVSD
189. SURGICAL REPAIR AND POSTOPERATIVE ECHO
190. Partial AVSD
191. Complete AVSD
192. Postoperative Echocardiographic Surveillance
193. SUMMARY
194. SUGGESTED READING
195. Chapter 8: Multiple Choice Question
196. 9 Ebstein Malformation and Tricuspid Valve Diseases
197. INTRODUCTION
198. ON THE NAMING OF THE TRICUSPID VALVAR APPARATUS
199. Ebstein Malformation
200. DEFINITION AND ANATOMIC FEATURES OF EBSTEIN MALFORMATION
201. CLINICAL PRESENTATION OF EBSTEIN MALFORMATION
202. ASSOCIATED CARDIOVASCULAR ABNORMALITIES
203. ECHOCARDIOGRAPHIC RECOGNITION AND EVALUATION OF EBSTEIN MALFORMATION
204. PRENATAL DETECTION OF EBSTEIN MALFORMATION
205. Other Tricuspid Valve Disorders
206. ACKNOWLEDGMENTS
207. SUGGESTED READING
208. Chapter 9: Multiple Choice Question
209. 10 Echocardiographic Assessment of Mitral Valve Abnormalities
210. INTRODUCTION
211. MITRAL VALVE EMBRYOLOGY AND GENETICS
212. ANATOMY OF THE MITRAL VALVE
213. Mitral Annular Shape and Function
214. Mitral Valve Leaflets
215. Tension Apparatus
216. MITRAL VALVE ABNORMALITIES
217. Incidence of Congenital Mitral Valve Abnormalities
218. SPECIFIC CONGENITAL MITRAL VALVE ABNORMALITIES
219. Mitral Valve Dysplasia, Hypoplasia, and Atresia
220. Supravalvar Mitral Ring
221. Parachute Mitral Valve
222. Mitral Valve Arcade
223. Double-Orifice Mitral Valve
224. Straddling Mitral Valve
225. Isolated Mitral Valve Cleft
226. Mitral Valve Prolapse
227. Dysplasia of the Posterior Mitral Valve Leaflet
228. ACQUIRED MITRAL VALVE DISEASE
229. Degenerative Mitral Valve
230. Flail Leaflet
231. Perturbations in Valve Function in the Premature Infant
232. Systolic Anterior Motion in Obstructive Hypertrophic Cardiomyopathy
233. Aortic Valve Insufficiency–Induced Mitral Restriction
234. Libman-Sacks Endocarditis
235. Infective Endocarditis of the Mitral Valve
236. MITRAL VALVE INTERVENTIONS
237. Interventions for Mitral Valve Pathology
238. FUTURE DIRECTIONS
239. 3D Printing and Fetal Imaging
240. Opportunities for Collaboration with Veterinary Cardiology
241. SUGGESTED READING
242. Chapter 10: Multiple Choice Question
243. 11 Congenitally Corrected Transposition of the Great Arteries
244. INTRODUCTION
245. ECHOCARDIOGRAPHIC ASSESSMENT
246. ASSOCIATED CARDIAC LESIONS
247. NATURAL HISTORY
248. ASSESSMENT OF THE SYSTEMIC RIGHT VENTRICLE
249. SUGGESTED READING
250. Chapter 11: Multiple Choice Question
251. 12 Ventricular Septal Defects
252. INTRODUCTION
253. ANATOMY OF THE VENTRICULAR SEPTUM
254. ANATOMY OF VENTRICULAR SEPTAL DEFECTS
255. ECHOCARDIOGRAPHIC ASSESSMENT OF VENTRICULAR SEPTAL DEFECTS
256. Ventricular Septal Defect Location
257. Special Considerations
258. Assessment of Ventricular Septal Defect Size
259. Evaluation of Right Heart Pressures
260. Quantification of Shunt Flow
261. CLOSURE OF VENTRICULAR SEPTAL DEFECTS
262. Spontaneous Closure
263. Surgical Repair
264. Transcatheter and Hybrid Perventricular Device Closure
265. ECHOCARDIOGRAPHY OF POSTOPERATIVE VENTRICULAR SEPTAL DEFECTS
266. VENTRICULAR SEPTAL DEFECTS IN THE FETUS
267. TRANSESOPHAGEAL ECHOCARDIOGRAPHY OF VENTRICULAR SEPTAL DEFECTS
268. SUGGESTED READING
269. Chapter 12: Multiple Choice Question
270. 13 Univentricular Atrioventricular Connections
271. INTRODUCTION
272. TRICUSPID ATRESIA
273. Associated Anomalies
274. Clinical History
275. Echocardiographic Examination of Tricuspid Atresia
276. HYPOPLASTIC LEFT HEART SYNDROME
277. Anatomy
278. Clinical Presentation
279. Echocardiography in Hypoplastic Left Heart Syndrome
280. Role of 3-Dimensional Echocardiography in Hypoplastic Left Heart Syndrome
281. RIGHT VENTRICULAR FUNCTIONAL ASSESSMENT IN HYPOPLASTIC LEFT HEART SYNDROME
282. VENTRICULOCORONARY ARTERY CONNECTIONS IN HYPOPLASTIC LEFT HEART SYNDROME
283. Borderline Left Ventricle
284. DOUBLE-INLET LEFT VENTRICLE
285. Anatomy of Double-Inlet Left Ventricle
286. Double-Inlet Left Ventricle with Transposed Great Arteries (Hypoplastic Subaortic Right Ventricle)
287. Double-Inlet Left Ventricle with Normally Related Great Arteries
288. Clinical Presentation
289. Echocardiographic Evaluation of Double-Inlet Left Ventricle
290. Interventricular Communication in Double-Inlet Left Ventricle or Tricuspid Atresia with Ventriculoarterial Discordance
291. APPROACH TO THE PATIENT WITH UNIVENTRICULAR ATRIOVENTRICULAR CONNECTION: SURGICAL PLANNING
292. The Neonate With Excessive Pulmonary Blood Flow
293. Echocardiographic Evaluation of Pulmonary Artery Band
294. The Neonate With Restricted Pulmonary Blood Flow
295. “The Balanced Infant”
296. The Neonate With Restricted Systemic Blood Flow
297. Modified Norwood Procedure
298. The Hybrid Procedure
299. Echocardiographic Evaluation Following Stage 1 Norwood Procedure
300. Echocardiographic Evaluation Following Hybrid Procedure
301. Echocardiographic Evaluation of the Bidirectional Cavopulmonary (Glenn) Anastomosis
302. Echocardiographic Evaluation of the Fontan Circulation
303. SUMMARY
304. SUGGESTED READING
305. Chapter 13: Multiple Choice Question
306. 14 Abnormalities of Right Ventricular Outflow
307. VALVAR PULMONARY STENOSIS
308. Background
309. Principles of Echocardiographic Anatomy and Imaging
310. SUBVALVAR PULMONARY STENOSIS
311. Background
312. Principles of Echocardiographic Anatomy and Imaging
313. SUPRAVALVAR PULMONARY STENOSIS
314. Background
315. Principles of Echocardiographic Anatomy and Imaging
316. PULMONARY REGURGITATION
317. Background
318. Principles of Echocardiographic Anatomy and Imaging
319. PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM
320. Background
321. Principles of Echocardiographic Anatomy and Imaging
322. POTENTIAL ROLES FOR ALTERNATIVE IMAGING MODALITIES IN RIGHT VENTRICULAR OUTFLOW TRACT ABNORMALITIES
323. Right Ventricular Size and Function
324. Physiologic Measures
325. Imaging of Pulmonary Artery Anatomy
326. SUGGESTED READING
327. Valvar Pulmonary Stenosis
328. Subvalvar Pulmonary Stenosis
329. Supravalvar Pulmonary Stenosis
330. Pulmonary Regurgitation
331. Pulmonary Atresia with Intact Ventricular Septum
332. Alternative Imaging Modalities in Right Ventricular Outflow Tract Obstruction
333. Chapter 14: Multiple Choice Question
334. 15 Abnormalities of Left Ventricular Outflow
335. INTRODUCTION
336. CLINICAL PRESENTATION
337. NORMAL ANATOMY
338. ABNORMAL ANATOMY AND COMMON ASSOCIATIONS
339. Valvar Aortic Stenosis
340. Subvalvar Aortic Stenosis
341. Supravalvar Aortic Stenosis
342. Aortic Regurgitation
343. Aneurysm of the Proximal Aorta
344. APPROACH TO TRANSTHORACIC ECHOCARDIOGRAPHY
345. Valvar Aortic Stenosis
346. Neonatal Critical Valvar Aortic Stenosis
347. Subvalvar Aortic Stenosis
348. Supravalvar Aortic Stenosis
349. Aortic Regurgitation
350. Aneurysm of the Proximal Aorta
351. FETAL ECHOCARDIOGRAPHY
352. TRANSESOPHAGEAL ECHOCARDIOGRAPHY
353. POSTOPERATIVE AND POSTINTERVENTIONAL ECHOCARDIOGRAPHY
354. Residual Left Ventricular Outflow Tract Obstruction
355. Residual or Postintervention Aortic Regurgitation
356. Left Ventricular Size and Function
357. Size of the Proximal Aorta
358. Prosthetic Aortic Valve Function
359. Alternative Imaging Modalities
360. SUGGESTED READING
361. Chapter 15: Multiple Choice Question
362. 16 Tetralogy of Fallot
363. INTRODUCTION
364. VENOUS CONNECTIONS
365. ATRIAL SEPTUM
366. ATRIOVENTRICULAR CONNECTIONS
367. VENTRICULAR SEPTAL DEFECT
368. Physiologic Assessment
369. Ventriculoarterial Connections
370. The Right Ventricular Outflow Tract
371. Pulmonary Valve
372. Great Arteries
373. Coronary Arteries
374. TETRALOGY OF FALLOT WITH ABSENT PULMONARY VALVE SYNDROME
375. PULMONARY ATRESIA WITH VENTRICULAR SEPTAL DEFECT
376. SURGICAL MANAGEMENT OF TETRALOGY OF FALLOT
377. SURGICAL REPAIR OF TETRALOGY OF FALLOT
378. POSTOPERATIVE ECHOCARDIOGRAPHIC EXAMINATION
379. Residual Shunts
380. Assessment of the Right Ventricular Outflow Tract
381. Assessment of Right Ventricular Systolic Function
382. Fractional Area Change
383. Tricuspid Annular Systolic Plane Excursion
384. Myocardial Performance Index
385. Tissue Doppler Imaging
386. Strain and Strain Rate Imaging
387. Three-Dimensional Echocardiography
388. Assessment of Right Ventricular Diastolic Function
389. CONCLUSION
390. SUGGESTED READING
391. Chapter 16: Multiple Choice Question
392. 17 d -Transposition of the Great Arteries
393. CLINICAL PRESENTATION
394. ANATOMY AND PHYSIOLOGY
395. INTERVENTIONAL AND SURGICAL MANAGEMENT
396. BASICS OF ECHOCARDIOGRAPHIC ANATOMY AND IMAGING
397. COMMON ASSOCIATED LESIONS AND FINDINGS THAT ALTER CLINICAL MANAGEMENT
398. INTERVENTIONAL AND POSTINTERVENTIONAL IMAGING
399. Preoperative Cardiac Catheterization
400. Intraoperative Imaging
401. Postoperative Imaging: Arterial Switch Operation
402. Postoperative Imaging: Atrial Switch Operation (Mustard or Senning Procedure)
403. Postoperative Imaging: Rastelli and Nikaidoh Procedures
404. POTENTIAL ROLES OF ADDITIONAL IMAGING MODALITIES
405. Preoperative Evaluation
406. Postoperative Evaluation
407. SUGGESTED READING
408. Chapter 17: Multiple Choice Question
409. 18 Double-Outlet Right and Left Ventricles
410. TERMINOLOGY
411. DOUBLE-OUTLET RIGHT VENTRICLE
412. Double-Outlet Right Ventricle With Side-by-Side Great Arteries and Subaortic Ventricular Septal Defect
413. IMAGING NOTES
414. Position of the Great Arteries
415. Position of the Ventricular Septal Defect
416. CORONARY ANOMALIES
417. PHYSIOLOGY
418. SURGICAL TREATMENT
419. DOUBLE-OUTLET LEFT VENTRICLE
420. Surgical Correction of Double-Outlet Left Ventricle
421. SUGGESTED READING
422. Chapter 18: Multiple Choice Question
423. 19 Truncus Arteriosus
424. INTRODUCTION
425. DEVELOPMENT AND ANATOMY
426. CLINICAL PRESENTATION
427. ASSOCIATED CONDITIONS
428. ECHOCARDIOGRAPHIC FEATURES
429. Two-Dimensional Echocardiographic Examination
430. Doppler Echocardiographic Examination
431. Preoperative Echocardiographic Evaluation of Truncus Arteriosus
432. Postoperative Echocardiographic Evaluation of Truncus Arteriosus
433. SUMMARY
434. SUGGESTED READING
435. Chapter 19: Multiple Choice Question
436. 20 Patent Ductus Arteriosus and Aortopulmonary Window
437. PATENT DUCTUS ARTERIOSUS
438. Two-Dimensional Echocardiography
439. Morphologic Variations in Patent Ductus Arteriosus
440. Ductal Origin of the Pulmonary Artery and Ductal Tissue Continuation of Branch Pulmonary Arteries
441. Hemodynamic Consequences of a Patent Ductus Arteriosus
442. Doppler Examination
443. Transesophageal Echocardiography
444. Ductal Aneurysm
445. Echocardiographic Limitations in Imaging the Patent Ductus Arteriosus
446. Echocardiographic Evaluation After Ductal Stent Placement
447. Echocardiographic Evaluation After Device Closure or Surgical Ligation of Patent Ductus Arteriosus
448. AORTOPULMONARY WINDOW
449. Two-Dimensional Echocardiography
450. Doppler Echocardiography
451. Echocardiographic Evaluation After Closure of an Aortopulmonary Window
452. SUGGESTED READING
453. Chapter 20: Multiple Choice Question
454. 21 Abnormalities of the Aortic Arch
455. INTRODUCTION
456. ABNORMALITIES OF BRACHIOCEPHALIC BRANCHING
457. Echocardiographic Assessment of the Aortic Arch
458. VASCULAR RINGS
459. Left Aortic Arch With Aberrant Right Subclavian Artery
460. Right Aortic Arch With Aberrant Left Subclavian Artery
461. Right Aortic Arch With Retroesophageal Segment and Left Descending Aorta
462. Double Aortic Arch
463. Pulmonary Artery Sling
464. Additional Imaging Modalities
465. COARCTATION OF THE AORTA
466. Two-Dimensional Imaging of Coarctation
467. Doppler Features of Coarctation
468. Imaging Following Coarctation Repair
469. Interrupted Aortic Arch
470. ACKNOWLEDGMENT
471. Key Points
472. SUGGESTED READING
473. Chapter 21: Multiple Choice Question
474. 22 Marfan Syndrome: Aortic Aneurysm and Dissection
475. INTRODUCTION
476. ANATOMY AND PHYSIOLOGY OF THE CARDIAC LESION
477. CLINICAL PRESENTATION
478. Marfan Syndrome in Children
479. CARDIAC COMPLICATIONS IN MARFAN SYNDROME
480. Cardiac Surgical Intervention
481. Pregnancy in Patients With MFS
482. BASICS OF ECHOCARDIOGRAPHIC ANATOMY AND IMAGING
483. Two-Dimensional Echocardiographic Anatomy and Hemodynamics
484. Echocardiographic Assessment of Aortic Dissection
485. How to Obtain Proper Echocardiographic and Doppler Images
486. ILLUSTRATIVE IMAGING EXAMPLES
487. Case 1: Aortic Root Enlargement in a Patient With MFS
488. Case 2: Mitral Valve Prolapse and Mitral Regurgitation in a Patient With MFS
489. Case 3: Imaging after Aortic Root and Valve Replacement in a Patient With MFS
490. Differential Diagnoses
491. Potential Imaging Pitfalls
492. Variations on Classic Anatomy
493. Common Associated Lesions and Findings
494. Key Findings That Alter Clinical Management
495. Interventional and Postinterventional Imaging
496. Potential Roles of Alternative Imaging Modalities
497. SUMMARY
498. SUGGESTED READING
499. Chapter 22: Multiple Choice Question
500. 23 Hypertrophic Cardiomyopathy
501. INTRODUCTION
502. DIAGNOSIS OF AND CLASSIFICATION SYSTEMS FOR HYPERTROPHIC CARDIOMYOPATHY
503. ECHOCARDIOGRAPHIC IMAGING IN HYPERTROPHIC CARDIOMYOPATHY
504. DOPPLER ECHOCARDIOGRAPHY
505. ASSESSMENT OF DIASTOLIC DYSFUNCTION
506. ROLE OF ECHOCARDIOGRAPHY DURING AND AFTER SURGICAL INTERVENTIONS
507. SUGGESTED READING
508. Chapter 23: Multiple Choice Question
509. 24 Additional Cardiomyopathies
510. INTRODUCTION
511. CLASSIFICATION OF CARDIOMYOPATHY
512. GENETICS OF CARDIOMYOPATHY AMONG CHILDREN
513. CHARACTERIZATION OF CARDIOMYOPATHIES
514. DILATED CARDIOMYOPATHY
515. CAUSES AND PREVALENCE OF DCM
516. THE CARDIAC CYTOSKELETON
517. GENETICS OF DCM
518. CLINICAL FEATURES OF DCM
519. TWO-DIMENSIONAL ECHOCARDIOGRAPHIC EVALUATION OF DCM
520. TISSUE DOPPLER IMAGING VELOCITIES IN DCM PATIENTS
521. MYOCARDIAL PERFORMANCE INDEX (TEI INDEX)
522. DP/DT MEASUREMENT AND FLOW PROPAGATION
523. STRAIN RATE IMAGING IN DCM
524. TREATMENT OF DCM
525. MECHANICAL DYSSYNCHRONY AND DCM
526. ECHOCARDIOGRAPHIC PREDICTORS OF OUTCOMES IN CHILDREN WITH DCM
527. MYOCARDITIS
528. RESTRICTIVE CARDIOMYOPATHY
529. LEFT VENTRICULAR NONCOMPACTION CARDIOMYOPATHY
530. ECHOCARDIOGRAPHIC FEATURES OF LVNC
531. ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA
532. DILATED CARDIOMYOPATHY ASSOCIATED WITH DUCHENNE MUSCULAR DYSTROPHY
533. STORAGE DISORDERS ASSOCIATED WITH CARDIOMYOPATHY
534. CHAGAS DISEASE
535. POSPARTUM CARDIOMYOPATHY
536. ANTHRACYCLINE-INDUCED CARDIOMYOPATHY
537. ARRHYTHMIA-INDUCED CARDIOMYOPATHY
538. TAKOTSUBO CARDIOMYOPATHY
539. RESPONSE OF DILATED CARDIOMYOPATHY TO ASSIST DEVICES
540. FETAL ECHOCARDIOGRAPHIC DIAGNOSIS OF CARDIOMYOPATHY
541. CONCLUSIONS
542. SUGGESTED READING
543. Chapter 24: Multiple Choice Question
544. 25 Pericardial Disorders
545. INTRODUCTION
546. CONGENITALLY ABSENT PERICARDIUM
547. PERICARDIAL CYST
548. PERICARDIAL EFFUSION/TAMPONADE
549. Pericardial Effusion Versus Pleural Effusion
550. Echocardiographically Guided Pericardiocentesis
551. CONSTRICTIVE PERICARDITIS
552. Pitfalls and Caveats
553. Restriction Versus Constriction
554. EFFUSIVE-CONSTRICTIVE PERICARDITIS
555. TRANSIENT CONSTRICTIVE PERICARDITIS
556. PERICARDIAL EFFUSION ASSOCIATED WITH MALIGNANCY
557. TRANSESOPHAGEAL ECHOCARDIOGRAPHY
558. CLINICAL IMPACT
559. SUGGESTED READING
560. Chapter 25: Multiple Choice Question
561. 26 Systemic Diseases
562. INTRODUCTION
563. RHEUMATIC FEVER
564. Goals of Imaging
565. Rheumatic Mitral Valve Disease
566. Rheumatic Aortic Valve Disease
567. KAWASAKI DISEASE
568. Goals of Imaging
569. AUTOIMMUNE DISEASES
570. Pericardial Involvement
571. Myocardial and Coronary Artery Involvement
572. Valvar Involvement
573. Pulmonary Vascular Involvement
574. Systemic Vascular Involvement
575. Neonatal Lupus Erythematosus
576. HUMAN IMMUNODEFICIENCY VIRUS INFECTION
577. Pericardial Involvement
578. Myocardial Involvement
579. Coronary Artery Involvement
580. Valvar Involvement
581. Pulmonary Vascular Involvement
582. Large-Vessel Arteriopathy
583. Cardiac Tumors
584. METABOLIC SYNDROME
585. Structural Changes
586. Functional Changes
587. Goals of Imaging
588. CARDIAC DISEASES IN CANCER PATIENTS
589. Myocardial Involvement
590. Pericardial Involvement
591. Valvar and Endocardial Involvement
592. Secondary Involvement of the Heart
593. Goals of Imaging
594. MYOCARDITIS
595. Goals of Imaging
596. SICKLE CELL DISEASE
597. Goals of Imaging
598. CHRONIC KIDNEY DISEASE
599. SUGGESTED READING
600. Chapter 26: Multiple Choice Question
601. 27 Vascular Abnormalities
602. ARTERIOVENOUS MALFORMATIONS
603. Systemic Arteriovenous Malformations
604. Pulmonary Arteriovenous Malformations
605. CORONARY ARTERY ABNORMALITIES
606. Echocardiography
607. Anomalous Origin of a Coronary Artery From the Pulmonary Artery
608. Anomalous Aortic Origin of a Coronary Artery From the Opposite Sinus of Valsalva
609. Coronary Artery Fistulas
610. Coronary Artery Aneurysms
611. Kawasaki Disease
612. SUGGESTED READING
613. Chapter 27: Multiple Choice Question
614. 28 Cardiac Tumors
615. INTRODUCTION
616. RHABDOMYOMA
617. MYXOMA
618. FIBROMA
619. HETEROTOPIAS AND GERM CELL TUMORS
620. HEMANGIOMA
621. PAPILLARY FIBROELASTOMA AND LAMBL EXCRESCENCES
622. PARAGANGLIOMA
623. MALIGNANT CARDIAC TUMORS
624. NONNEOPLASTIC CARDIAC MASSES
625. SUGGESTED READING
626. Chapter 28: Multiple Choice Question
627. 29 Evaluation of the Transplanted Heart
628. ABBREVIATIONS
629. INTRODUCTION
630. History
631. Current Incidence and Outcomes
632. Importance of Echocardiography
633. ECHO EVALUATION PRIOR TO TRANSPLANT
634. Evaluation of Potential Donors
635. Evaluation of Potential Recipients
636. ECHO EVALUATION DURING TRANSPLANT
637. Intraoperative TEE
638. Residual Cardiac Lesions
639. ECHO EVALUATION AFTER TRANSPLANT
640. Acute Allograft Rejection
641. Common Findings of Rejection
642. Echo Markers When Rejection is Not Obvious
643. Long-Term Follow-up of Residual Lesions
644. Monitoring During Biopsy
645. Home Monitoring Programs
646. CORONARY ARTERY VASCULOPATHY
647. Intravascular Ultrasound
648. Stress Echocardiography
649. SUMMARY
650. SUGGESTED READING
651. Chapter 29: Multiple Choice Question
652. 30 Pulmonary Hypertension
653. LEARNING OBJECTIVES
654. BACKGROUND AND EPIDEMIOLOGY
655. ECHOCARDIOGRAPHIC ASSESSMENT OF HEMODYNAMICS IN PULMONARY HYPERTENSION
656. Indirect Signs of Pulmonary Hypertension
657. Doppler Assessment of Pulmonary Artery Pressures in Pulmonary Hypertension
658. Doppler Estimates of Pulmonary Vascular Resistance
659. EVALUATION OF RIGHT VENTRICLE–PULMONARY ARTERY COUPLING AND RIGHT VENTRICULAR FUNCTION
660. Assessment of the Cardiopulmonary Unit
661. Assessment of Right Ventricular Function
662. POPULATIONS AT RISK FOR PULMONARY HYPERTENSION
663. Premature Infants With Bronchopulmonary Dysplasia
664. Screening for Pulmonary Hypertension in Other Populations
665. OTHER ANATOMIC CONSIDERATIONS
666. Key Points
667. SUGGESTED READING
668. Chapter 30: Multiple Choice Question
669. 31 Echocardiography in the Diagnosis and Management of Endocarditis
670. BACKGROUND
671. RISK FACTORS
672. PATHOGENESIS
673. CLINICAL PRESENTATION
674. COMPLICATIONS
675. DIAGNOSIS
676. MANAGEMENT
677. PROGNOSIS
678. PROPHYLAXIS
679. IMPORTANT ECHOCARDIOGRAPHIC CONSIDERATIONS
680. Vegetations
681. Abscesses and Fistulae
682. Embolism, Ventricular Dysfunction, and Pericarditis
683. Prosthetic Valves and Conduits
684. Role of Transesophageal and Intracardiac Echocardiography and Other Imaging Modalities
685. IMPORTANT ECHOCARDIOGRAPHIC SUGGESTIONS
686. SUGGESTED READING
687. Chapter 31: Multiple Choice Question
688. 32 Evaluation of Prosthetic Valves
689. Introduction
690. EVALUATION OF THE MITRAL PROSTHESIS
691. EVALUATION OF THE AORTIC PROSTHESIS
692. EVALUATION OF TRICUSPID AND PULMONARY PROSTHESES
693. PERCUTANEOUS VALVE IMPLANTATION
694. PROSTHESIS-PATIENT MISMATCH
695. PRESSURE RECOVERY
696. SUGGESTED READING
697. Chapter 32: Multiple Choice Question
698. 33 Fetal Echocardiography
699. Introduction
700. INDICATIONS FOR FETAL ECHOCARDIOGRAPHY
701. TIMING OF FETAL ECHOCARDIOGRAPHY
702. SYSTEMATIC APPROACH
703. Fetal Position
704. Echocardiographic Imaging of the Great Arteries
705. Longitudinal Views
706. DETECTION RATES OF FETAL CARDIAC ABNORMALITIES
707. MEASUREMENTS OF THE FETAL HEART
708. FETAL CARDIAC FUNCTION
709. FETAL ECHOCARDIOGRAPHY AND MRI
710. FETAL ARRHYTHMIAS
711. MANAGEMENT FOLLOWING A PRENATAL DIAGNOSIS OF CHD
712. IMPACT ON OUTCOME
713. FETAL INTERVENTION
714. SUGGESTED READING
715. Chapter 33: Multiple Choice Question
716. 34 Three-Dimensional Echocardiography in Congenital Heart Disease
717. INTRODUCTION
718. INSTRUMENTATION AND WORKFLOW
719. DATA ACQUISITION MODES AND PRINCIPLES OF ACQUISITION
720. 2D Simultaneous Multiplane Mode
721. Real-time/Live 3DE Mode
722. ECG-triggered MultiBeat Acquisitions
723. 3DE Color Flow Doppler
724. Principles of Acquisition
725. 3DE IMAGE DISPLAY MODES AND ORIENTATION
726. 3DE Image Orientation—Surgical Versus Anatomic View
727. OPTIMAL ACQUISITION AND SONOGRAPHIC PROJECTIONS FOR THE VARIOUS CHD
728. ADDED CLINICAL UTILITY OF 3DE OVER 2DE IN CHD
729. 3DE TO GUIDE CATHETER INTERVENTION
730. 3DE FOR QUANTIFICATION OF VENTRICULAR VOLUMES AND FUNCTION
731. 3DE Assessment of the Left Ventricle
732. 3DE Assessment of the Right Ventricle
733. 3DE Assessment of the Single Ventricle
734. 3DE ASSESSMENT OF THE VALVE MORPHOLOGY AND FUNCTION
735. LEARNING CURVE
736. FUTURE DIRECTIONS
737. SUGGESTED READING
738. Chapter 34: Multiple Choice Question
739. 35 3D Printing and Its Use in Congenital Heart Disease
740. INTRODUCTION
741. GOALS OF 3D PRINTING
742. PROCESS
743. Acquisition of 3D Data Set
744. Computed Tomography
745. Magnetic Resonance Imaging
746. Echocardiography
747. Modality Co-Registration
748. VIRTUAL MODEL CREATION
749. Printing
750. CURRENT APPLICATIONS
751. Model Types
752. Surgical/Interventional Catheterization Planning and Simulation
753. Education and Patient Counseling
754. LIMITATIONS
755. CONCLUSIONS
756. SUGGESTED READING
757. 36 Stress Echocardiography
758. INTRODUCTION
759. EVOLUTION OF STRESS ECHOCARDIOGRAPHY SCIENCE
760. PHYSIOLOGIC THEORY BEHIND STRESS ECHOCARDIOGRAPHY
761. INDICATIONS
762. Bayes Theorem
763. Coronary Artery Disease
764. Ventricular Contractile Reserve
765. Pressure Dynamics
766. PREPARATION
767. Training
768. Stressors
769. Sensors
770. Personnel
771. Equipment
772. Transpulmonary Contrast Agents
773. CONTRAINDICATIONS AND POTENTIAL COMPLICATIONS
774. OUTPUTS AND INTERPRETATION
775. Accuracy
776. Prognostic Significance
777. CONCLUSION
778. SUGGESTED READING
779. Chapter 36: Multiple Choice Question
780. 37 Intracardiac and Intraoperative Transesophageal Echocardiography
781. INTRACARDIAC ECHOCARDIOGRAPHY
782. Equipment
783. Examination
784. Image Acquisition
785. Applications
786. CONGENITAL INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY
787. Equipment
788. Image Acquisition
789. Mayo Clinic Intraoperative and Interventional Catheterization Experience
790. Intraoperative Transesophageal Echocardiography Using the Intracardiac Echocardiography Probe
791. SUGGESTED READING
792. Chapter 37: Multiple Choice Question
793. 38 Interventional Echocardiography in Congenital Heart Disease
794. OVERVIEW
795. ECHOCARDIOGRAPHIC MODALITIES
796. PRE- AND POSTPROCEDURE ECHOCARDIOGRAPHY
797. COMMUNICATION BETWEEN IMAGER AND INTERVENTIONALIST
798. ATRIAL SEPTAL DEFECT AND PATENT FORAMEN OVALE DEVICE CLOSURE
799. Preintervention Echocardiographic Assessment
800. Intraprocedure Echocardiographic Assessment
801. Postprocedure Echocardiographic Assessment
802. VENTRICULAR SEPTAL DEFECT DEVICE CLOSURE
803. Preintervention Echocardiographic Assessment
804. Intraprocedure Echocardiographic Assessment
805. Postprocedure Echocardiographic Assessment
806. CLOSURE OF FISTULAE
807. Preintervention Echocardiographic Assessment
808. Intraprocedure Echocardiographic Assessment
809. Postprocedure Echocardiographic Assessment
810. BALLOON ATRIAL SEPTOSTOMY
811. Preintervention Echocardiographic Assessment
812. Intraprocedure Echocardiographic Assessment
813. Postprocedure Echocardiographic Assessment
814. OTHER PROCEDURES
815. Endomyocardial Biopsy
816. Transseptal Puncture
817. Pericardiocentesis
818. SUMMARY
819. SUGGESTED READING
820. Chapter 38: Multiple Choice Question
821. 39 Echocardiographic Assessment of Mechanical Circulatory Support
822. INTRODUCTION
823. Background
824. Importance of Echocardiography
825. ECHO ASSESSMENT BEFORE MCS PLACEMENT
826. Diagnosis
827. Valve Function
828. Shunts
829. Thrombus Formation
830. INTRAOPERATIVE ASSESSMENT OF MCS
831. Cannula Position
832. De-airing
833. Right Ventricular Function
834. ECHO ASSESSMENT OF MCS AFTER PLACEMENT
835. Inflow/Outflow Obstruction
836. Thrombus Formation
837. Valvar Regurgitation
838. Recovery of Function
839. Direct Echo Assessment of Berlin Heart
840. VADS IN THE OUTPATIENT SETTING
841. SPECIFIC MCS CONSIDERATIONS
842. Extracorporeal membrane oxygenation
843. Impella Device
844. SUGGESTED READING
845. Chapter 39: Multiple Choice Question
846. 40 Cardiac Magnetic Resonance and Computed Tomographic Imaging in Congenital Heart Disease
847. INTRODUCTION
848. COMPUTED TOMOGRAPHY
849. General Principles
850. Technical Aspects
851. Postacquisition Image Processing
852. MAGNETIC RESONANCE IMAGING
853. General Principles
854. Technical Aspects
855. Anatomic Assessment
856. Functional and Physiological Assessment
857. Tissue Characterization
858. Postacquisition Image Processing
859. CLINICAL APPLICATIONS AND CASE EXAMPLES
860. Shunt Lesions
861. Aortic Anomalies
862. Pulmonary Artery Anomalies
863. Systemic and Pulmonary Venous Anomalies
864. Tetralogy of Fallot
865. Complete Transposition of the Great Arteries
866. Congenitally Corrected Transposition
867. Heterotaxy Syndrome
868. Single Ventricle
869. Cardiomyopathies
870. Coronary Artery Anomalies
871. Ebstein Anomaly
872. SUGGESTED READING
873. Chapter 40: Multiple Choice Question
874. 41 Adults With d-Transposition After Surgical Palliation/Repair
875. INTRODUCTION
876. HISTORICAL PERSPECTIVE
877. ADULTS AFTER ATRIAL SWITCH OPERATION
878. FUNCTIONAL ASSESSMENT OF THE SYSTEMIC RIGHT VENTRICLE
879. LONG-TERM ISSUES AFTER ARTERIAL SWITCH OPERATION
880. RASTELLI AND NIKAIDOH OPERATIONS FOR d-TGA, VSD, AND LVOT OBSTRUCTION
881. ACKNOWLEDGMENTS
882. SUGGESTED READING
883. Chapter 41: Multiple Choice Question
884. 42 Tetralogy of Fallot With Pulmonary Regurgitation
885. INTRODUCTION
886. ETIOLOGY AND SEVERITY OF PULMONARY REGURGITATION
887. RIGHT VENTRICULAR OUTFLOW TRACT
888. RIGHT VENTRICULAR SIZE AND SYSTOLIC FUNCTION
889. RIGHT VENTRICULAR DIASTOLIC DYSFUNCTION
890. RIGHT ATRIAL SIZE AND FUNCTION
891. TRICUSPID REGURGITATION
892. RESIDUAL SHUNT LESIONS
893. LEFT-SIDED CARDIAC CONSIDERATIONS
894. CARDIAC IMAGING INFLUENCE ON TIMING OF SUBSEQUENT INTERVENTIONS
895. SUMMARY
896. SUGGESTED READING
897. Chapter 42: Multiple Choice Question
898. 43 Echocardiographic Evaluation of the Functionally Univentricular Heart After Fontan “Operation”
899. INTRODUCTION
900. ANATOMY AND PHYSIOLOGY OF THE FONTAN OPERATION
901. IMAGING STRATEGIES FOR EVALUATION OF PATIENTS AFTER FONTAN OPERATIONS
902. IMAGE ACQUISITION AND THE ANATOMY OF THE FONTAN RECONSTRUCTION
903. ASSESSMENT OF VENTRICULAR PERFORMANCE
904. VENOUS AND ARTERIAL PATHWAY OBSTRUCTIONS
905. PROBLEMS ASSOCIATED WITH ATRIAL ENLARGEMENT
906. ECHOCARDIOGRAPHIC CLUES TO A FAILING FONTAN CIRCULATION
907. ILLUSTRATIVE CASES INVOLVING PATIENTS WITH FONTAN CIRCULATIONS
908. Case 1
909. Case 2
910. Case 3
911. Case 4
912. SUMMARY
913. SUGGESTED READING
914. Chapter 43: Multiple Choice Question
915. 44 Eisenmenger Syndrome
916. INTRODUCTION
917. PATHOPHYSIOLOGY
918. CLINICAL FEATURES
919. Physical Examination
920. Hematologic Abnormalities
921. Other Associated Conditions
922. ECHOCARDIOGRAPHIC FINDINGS
923. Assessment of Right Ventricular Function
924. Echocardiographic Markers of Prognosis
925. SURVIVAL AND EFFECTS OF PULMONARY VASOMODULATOR THERAPY
926. Medical Therapy for Pulmonary Arterial Hypertension
927. SUGGESTED READING
928. Chapter 44: Multiple Choice Question
929. INDEX