Suprasternal notch echocardiography: a two-dimensional technique for evaluating congenital heart disease

Two-dimensional suprasternal notch echocardiography was performed in 1033 patients, ages 1 day to 18 years. For the long-axis suprasternal notch view, the transducer was positioned in the suprasternal notch and angled to obtain a plane passing between the right nipple and left scapular tip. In this view, the entire aortic arch, vessels to the head and neck, right pulmonary artery and right bronchus were imaged. The long-axis view was useful for evaluating coarctation and interruption of the aorta, hypoplastic left heart, aortic and pulmonic stenosis and cervical aortic arch. For the short-axis suprasternal notch view the transducer was positioned in the suprasternal notch and angled to obtain a coronal body plane. In this view the transverse aorta, right pulmonary artery, left atrium, innominate veins and superior vena cava were imaged. The short-axis view was useful in the evaluation of children with increased or decreased pulmonary blood flow, persistent left superior vena cava, total anomalous pulmonary venous return to the right superior vena cava, and superior vena caval obstruction after Mustard's operation. In the evaluation of children with congenital heart disease, the suprasternal notch views added significant information to the two-dimensional echocardiographic examination.