Two-dimensional echocardiography in the older child

Area of Science:

• Pediatric Cardiology
• Medical Imaging
• Congenital Heart Disease

Background:

• The management of congenital cardiovascular anomalies in older children relies on understanding lesion natural history and surgical options.
• Two-dimensional echocardiography (2D echo) is a key imaging modality for assessing these conditions and their surgical outcomes.

Purpose of the Study:

• To illustrate the application of 2D echocardiography in managing specific congenital heart anomalies in older children.
• To highlight the utility of 2D echo in diagnostic assessment and postoperative follow-up of complex pediatric cardiac surgeries.

Main Methods:

• Utilized 2D echocardiography for anatomical and functional assessment of left ventricular outflow obstruction.
• Employed combined 2D imaging with gated pulsed Doppler techniques to evaluate Fontan, Mustard/Senning procedures, and Tetralogy of Fallot reconstructions.
• Assessed pulmonary and systemic venous return to neo-atria after Senning/Mustard procedures.

Main Results:

• 2D echocardiography effectively displays static anatomy and dynamic function in left ventricular outflow obstruction.
• Combined imaging with Doppler improved assessment of Fontan reconstructions and venous return after Senning/Mustard procedures.
• Prosthetic materials in Tetralogy of Fallot repairs limited echocardiographic assessment of outflow tract and septal closure.

Conclusions:

• 2D echocardiography, especially when combined with Doppler, is valuable for managing complex congenital heart disease in older children.
• Limitations exist, particularly with prosthetic materials, necessitating advancements in tissue characterization for improved imaging accuracy.