Advertisement

Adult Congenital Heart Disease

  • Swapnil KhocheEmail author
Chapter

Abstract

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.

Keywords

TEE 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 

Supplementary material

Video 13.1

Midesophageal view of interatrial septum with color flow Doppler in a patient with a patent foramen ovale (PFO) (AVI 10,209 KB)

Video 13.2

Midesophageal view of interatrial septum during agitated saline injection demonstrating a patent foramen ovale (PFO) (AVI 46,007 KB)

Video 13.3

Midesophageal four chamber view demonstrating an ostium secundum ASD with left to right flow demonstrated on color flow Doppler (AVI 3,439 KB)

Video 13.4

Midesophageal four chamber view demonstrating an ostium primum ASD (AVI 14,945 KB)

Video 13.5

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)

Video 13.6

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)

330609_1_En_13_MOESM7_ESM.avi (22.3 mb)
Video 13.7 Midesophageal long axis view in a patient with an outlet VSD. Color flow Doppler demonstrates left to right flow from the left ventricular outflow tract to the right ventricular outflow tract (AVI 22,790 KB)
Video 13.8

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)

330609_1_En_13_MOESM9_ESM.avi (1.7 mb)
Video 13.9 Midesophageal long-axis view in a patient with tetralogy of fallot s/p VSD repair. Note the overriding aorta that remains and the evidence of right ventricular hypertrophy. Incidentally, there is a dilated coronary sinus in this patient that was a persistent left-sided superior vena cava (AVI 1,786 KB)

References

  1. 1.
    Miller-Hance WC, Russell IA. Intraoperative and Postoperative Transesophageal Echocardiography in Congenital Heart Disease. In: Wong PC, Miller-Hance WC (eds) Transesophageal echocardiography for congenital heart disease (internet). Springer, London; 2014. 2015. p. 383–97. Available from: http://link.springer.com/chapter/10.1007/978-1-84800-064-3_15.Google Scholar
  2. 2.
    Webb G, Mulder BJ, Aboulhosn J, Daniels CJ, Elizari MA, Hong G, et al. The care of adults with congenital heart disease across the globe: current assessment and future perspective: a position statement from the International Society for Adult Congenital Heart Disease (ISACHD). Int J Cardiol. (Internet). 2015. Available from: http://www.sciencedirect.com/science/article/pii/S016752731500964X.
  3. 3.
    Reeves ST, Finley AC, Skubas NJ, Swaminathan M, Whitley WS, Glas KE, et al. Basic perioperative transesophageal echocardiography examination: a consensus statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2013;26(5):443–56.CrossRefPubMedGoogle Scholar
  4. 4.
    Hara H, Virmani R, Ladich E, Mackey-Bojack S, Titus J, Reisman M, et al. Patent foramen ovale: current pathology, pathophysiology, and clinical status. J Am Coll Cardiol. 2005;46(9):1768–76.CrossRefPubMedGoogle Scholar
  5. 5.
    Craig RJ, Selzer A. Natural history and prognosis of atrial septal defect. Circulation. 1968;37(5):805–15.CrossRefPubMedGoogle Scholar
  6. 6.
    Minette MS, Sahn DJ. Ventricular septal defects. Circulation. 2006;114(20):2190–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Kamran M, Attari M, Webber G. Ventricular septal defect complicating an acute myocardial infarction. Circulation. 2005;112(22):e337–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Ishii M, Hashino K, Eto G, Tsutsumi T, Himeno W, Sugahara Y, et al. Quantitative assessment of severity of ventricular septal defect by three-dimensional reconstruction of color doppler-imaged vena contracta and flow convergence region. Circulation. 2001;103(5):664–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Backer CL, Winters RC, Zales VR, Takami H, Muster AJ, Benson DWJ, et al. Restrictive ventricular septal defect: How small is too small to close? Ann Thorac Surg. 56(5):1014–9.Google Scholar
  10. 10.
    Sarodia BD, Stoller JK. Persistent left superior vena cava: case report and literature review. Respir Care. 2000;45(4):411–6.PubMedGoogle Scholar
  11. 11.
    Wiyono SA, Witsenburg M, de Jaegere PPT, Roos-Hesselink JW. Patent ductus arteriosus in adults. Neth Heart J. 2008;16(7–8):255–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Rigby ML. Closure of a large patent ductus arteriosus in adults: first do no harm. Heart. 2007;93(4):417–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of California San DiegoSan DiegoUSA

Personalised recommendations