The univentricular heart: combined 2-dimensional-pulsed Doppler (duplex) echocardiographic evaluation

Two-dimensional echocardiographic-pulsed Doppler (2D-PD) evaluation was performed in 14 patients with a univentricular heart. Accurate information on ventricular structure, atrioventricular valve status, and great vessel anatomy and function was obtained. The characteristic morphologic features were verified in each case by angiography or autopsy, or both. In several patients, 2D-PD evaluation provided more accurate anatomic and functional information than did cardiac angiography in standard views, particularly with regard to atrioventricular valve function. Four children with pulmonary atresia and 4 with pulmonary stenosis were identified prospectively. No patient had 2D-PD evidence of aortic obstruction. Four children had typical 2D-PD patterns consistent with atrioventricular valve regurgitation. Thus, 2D echocardiography coupled with a range-gated Doppler system will improve recognition of patients with a univentricular heart and permit thorough evaluation of specific anatomic details.