Adult Congenital Heart Disease
The increasing number of patients with either uncorrected or repaired congenital cardiac lesions is on the rise, likely reflective of improvements in care and detection. With more patients surviving well into adulthood, they often present for non-cardiac surgery. Echocardiography remains central to the detection, and aids in both surgical and device-based correction. It can also provide important prognostic information and quantify the effects (from the lesion) on ventricular function, pulmonary and systemic flow, etc. It is important for the beginner and intermediate practitioner to familiarize himself/herself with basic lesions encountered in adulthood, the echocardiographic techniques used to further identify and evaluate each condition, and the associated conditions that need to be sought and ruled out.
KeywordsTEE for congenital heart disease Ventricular septal defect Atrial septal defect Patent foramen ovale Bubble study Dilated coronary sinus Persistent left SVC PDA Device closure Tetralogy of fallot
Midesophageal view of interatrial septum with color flow Doppler in a patient with a patent foramen ovale (PFO) (AVI 10,209 KB)
Midesophageal view of interatrial septum during agitated saline injection demonstrating a patent foramen ovale (PFO) (AVI 46,007 KB)
Midesophageal four chamber view demonstrating an ostium secundum ASD with left to right flow demonstrated on color flow Doppler (AVI 3,439 KB)
Midesophageal four chamber view demonstrating an ostium primum ASD (AVI 14,945 KB)
Midesophageal bicaval view in a patient with a superior sinus venosus ASD and a grossly dilated right atrium (RA). Color flow Doppler confirms left to right flow (AVI 1,637 KB)
Midesophageal right ventricular inflow-outflow view in a patient with a perimembranous ventricular septal defect (VSD). Color flow Doppler confirms left to right flow (AVI 7,053 KB)
Midesophageal two chamber view with the dilated coronary sinus in cross section to the posterior aspect of the top of the left ventricle. Agitated saline injected into the left arm has resulted in “microbubbles” within the dilated coronary sinus, confirming a persistent left superior vena cava (AVI 35,544 KB)
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