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Table of Contents
VIDEO COMMENTARY  
Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 143
Transesophageal echocardiography for dextro - transposition of great arteries


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Date of Web Publication31-Dec-2015
 

How to cite this article:
Kapoor PM, Narula J. Transesophageal echocardiography for dextro - transposition of great arteries. Ann Card Anaesth 2016;19:143

How to cite this URL:
Kapoor PM, Narula J. Transesophageal echocardiography for dextro - transposition of great arteries. Ann Card Anaesth [serial online] 2016 [cited 2019 Dec 5];19:143. Available from: http://www.annals.in/text.asp?2016/19/1/143/173032


CHAMBER IDENTIFICATION

In the ME four-chamber view:-

€ The morphologic RV is characterized by inferior insertion of the septal leaflet of the tricuspid valve to the ventricular septum and by the moderator band.

€ The right ventricle is identified by the presence of more apically placed trileaflet atrioventricular valve, presence of moderator band and coarse trabeculations.

ASSESSMENT OF VENTRICULAR OUTFLOW TRACTS

€ Pulmonary valve assessment has long term implications as it is going to form future valve towards systemic circulation after ASO. Measure annulus.

€ Determine if valve is bicuspid or tricuspid. Assess for any regurgitation or stenosis. Left ventricular outflow tract - size, any accessory mitral tissue or membrane causing obstruction.

€ Continuous wave Doppler for assessment of left ventricular outflow tract.

EVALUATION OF SHUNTS

Evaluation of VSD:-

€ VSD may be Sub-aortic or mid muscular, € Size may vary from small restrictive VSD to Large VSDs with bidirectional shunting

TRANSGASTRIC MID PAPILLARY SHORT AXIS VIEW SHOWING THE COMPARATIVE SHAPES AND SIZES OF BOTH THE VENTRICLES

€ 2D echo for evaluation of regressed left ventricle in

transposition of great arteries. € Note the banana-shaped left ventricle and well

developed right ventricle. € The interventricular septum is convex towards left

ventricle and moves with the right ventricle. € Not shown here is the measurement of the thickness

of the interventricular septum, posterior wall of left

ventricle and internal diameter of left ventricle on

basis of which left ventricular mass may be calculated. € This subset of patients are at high-risk of left

ventricular failure after arterial switch operations.

ASSESSMENT OF AV VALVES

ME 4C view showing the comparative sizes of right and

left ventricle inflow^

€ On gross inspection, it appears the left ventricle is

small € Underdevelopment or "regression". € Regressed Left Ventricle € Mitral valve annulus is normal and left ventricle is

small when adjusted for body surface area € Underdeveloped Left Ventricle € Mitral valve is hypo plastic and left ventricle is small

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Correspondence Address:
Poonam Malhotra Kapoor
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Source of Support: None, Conflict of Interest: None


PMID: 26750686

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  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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