Echocardiography: an overview - Part II

Abstract

This review describes echocardiographic features of commonly encountered acyanotic congenital heart defects. Echo-Doppler features of lesions causing obstruction, namely aortic stenosis, aortic coarctation, stenosis of the pulmonary valve and pulmonary arteries were initially presented followed by discussion of lesions with left-to-right shunt namely, atrial and ventricular septal defects, patent foramen ovale, patent ductus arteriosus (PDA), and atrioventricular septal defect. A special section dedicated to evaluating hemodynamically significant PDAs in premature infants was also included. Coronary artery anomalies (both congenital and acquired) were reviewed at the conclusion of the paper.

Keywords

Echocardiography / aortic stenosis / aortic coarctation / pulmonary stenosis / atrial septal defect / ventricular septal defect / patent ductus arteriosus / muco-cutaneous lymph node syndrome

References

[1] Rao PS.Diagnosis and management of acyanotic heart disease: Part I - obstructive lesions.Indian J Pediatr2005;72:496-502

[2] Singh GK.Left heart outflow obstructions.Cardiology2010;1507-18

[3] Rao PS. Congenital heart defects - a review. In: Rao PS, editor. Congenital heart disease - selected aspects. Rijeka, Croatia: InTech; 2012. p. 3-44.

[4] Rao PS. Echocardiographic evaluation of neonates with suspected heart disease. In: Rao PS, Vidyasagar D, editors. A multidisciplinary approach to perinatal cardiology, Volume 1. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2021. p. 314-408.

[5] Singh GK,Oliver D.Pressure gradients in outflow stenotic lesions: A simultaneous Doppler and catheter correlative study in pediatric patients (Abstract).J Am Soc Echocardiogr2000;13:455

[6] Singh GK,Marino C,Rao PS.Effect of pressure recovery on pressure gradients in congenital stenotic outflow lesions in pediatric patients-clinical implications of lesion severity and geometry: a simultaneous Doppler echocardiography and cardiac catheter correlative study.J Am Soc Echocardiogr2020;33:207-17

[7] Nguyen TQ,Schmidt MR.Transthoracic vector flow imaging in pediatric patients with Valvular stenosis - a proof of concept study.Ultrasound Int Open2021;7:E48-54 PMCID:PMC8598391

[8] Galal O,Al-fadley F.Follow-up results of balloon aortic valvuloplasty in children with special reference to causes of late aortic insufficiency.Am Heart J1997;133:418-27

[9] Rao PS.Coarctation of the aorta.Semin Nephrol1995;15:81-105

[10] Rao PS. Coarctation of the aorta. In: Rao PS, Vidyasagar D, editors. A multidisciplinary approach to perinatal cardiology, Volume 2. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2021. p. 518-40.

[11] Rao P, Carey P. Doppler ultrasound in the prediction of pressure gradients across aortic coarctation.Am Heart J1989;118:299-307

[12] Rao PS,Smith PA.Five- to nine-year follow-up results of balloon angioplasty of native aortic coarctation in infants and children.J Am Coll Cardiol1996;27:462-70

[13] Siblini G,Nouri S,Jureidini SB.Long-term follow-up results of balloon angioplasty of postoperative aortic recoarctation.Am J Cardiol1998;81:61-7

[14] Sahu R.Transcatheter stent therapy in children: an update.Pediat Therapeut2012;5:1

[15] Rao PS. Pulmonary valve disease. In: Alpert JS, Dalen JE, Rahimtoola, editors. Valvular heart disease. Philadelphia, PA: Lippincott Raven; 2000. p. 339-76.

[16] Rao PS. Other acyanotic heart defects presenting in the neonate. In: Rao PS, Vidyasagar D, editors. A multidisciplinary approach to perinatal cardiology, Volume 2. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2021. p. 615-54.

[17] Rao PS. Pulmonary stenosis. In: Rao PS, editor. Pediatric cardiology: how it has evolved over the last 50 years. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2020. p. 185-230.

[18] Rao P.Doppler ultrasound in the prediction of transvalvar pressure gradients in patients with valvar pulmonary stenosis.Int J Cardiol1987;15:195-203

[19] Rao PS. Balloon pulmonary valvuloplasty for isolated pulmonic stenosis. In: Rao PS, editor. Transcatheter therapy in pediatric cardiology. New York: Wiley-Liss, Inc.; 1993. p. 59-104.

[20] Rao PS,Patnana M,Wilson AD.Results of three to 10 year follow up of balloon dilatation of the pulmonary valve.Heart1998;80:591-5 PMCID:PMC1728864

[21] Rao PS.Perinatal circulatory physiology.Indian J Pediat1991;58:441-51

[22] Rao PS. Fetal and neonatal circulation. In: Kambam J, editor. Cardiac anesthesia for infants and children. St. Louis, MO: Mosby-Year Book; 1994. p. 10-9.

[23] Rao PS. Perinatal circulatory physiology. In: Rao PS, Vidyasagar D, editors. A multidisciplinary approach to perinatal cardiology, Volume 1. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2021. p. 2-18.

[24] Rao P. Diagnosis and management of acyanotic heart disease: part II -- left-to-right shunt lesions.Indian J Pediatr2005;72:503-12

[25] Rao PS. Atrial septal defect: a review. In: Rao PS, editor. Atrial septal defect; Rijeka, Croatia: InTech; 2012. p. 3-20.

[26] Rao P,Hausdort G.International experience with secundum atrial septal defect occlusion by the buttoned device.Am Heart J1994;128:1022-35

[27] Rao P,Levy JM,Chopra PS.Role of “buttoned” double-disc device in the management of atrial septal defects.Am Heart J1992;123:191-200

[28] Pedra CAC,Esteves CA.Transcatheter closure of secundum atrial septal defects with complex anatomy.J Invasive Cardiol2004;16:117-22

[29] Podnar T,Gavora P.Morphological variations of secundum-type atrial septal defects: feasibility for percutaneous closure using Amplatzer septal occluders.Catheter Cardiovasc Interv2001;53:386-91

[30] Rao PS. Non-surgical closure of atrial septal defects in children. In: Larkin SA, editor. Atrial and ventricular septal defects: molecular determinants, impact of environmental factors and non-surgical interventions. Nova Science Publishers, Inc.; 2013.

[31] Rao PS. Atrial septal defect. In: Rao PS, editor. Pediatric cardiology: how it has evolved over the last 50 years. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2020. p. 321-86.

[32] Hagen PT,Edwards WD.Incidence and size of patent foramen Ovale during the first 10 decades of life: an autopsy study of 965 normal hearts.Mayo Clin Proc1984;59:17-20

[33] Rees AH,Rigby JJ.Echocardiographic estimation of left-to-right shunt in isolated ventricular septal defects.Eur J Cardiol1978;7:25-33

[34] Rao PS. Ventricular and atrio-ventricular septal defects. In: Rao PS, editor. Pediatric cardiology: how it has evolved over the last 50 years. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2020. p. 452-85.

[35] Rao PS.Doppler echocardiography in non-invasive diagnosis of heart disease in infants and children.Indian J Pediatr1988;55:80-95

[36] Rao PS.Role of echocardiography in the evaluation of preterm infants with patent ductus arteriosus.Congenital Cardiology Today2018;16:1-10

[37] Naidu DP,Rao PS. Patent ductus arteriosus. In: Rajiv PK, Lakshminrusimha S, Vidyasagar D, editors. Essentials of neonatal ventilation. Elsevier; 2018. p. 1-30.

[38] Rao PS.In: Rao PS, Vidyasagar D, editors. A multidisciplinary approach to perinatal cardiology, Volume 2. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2021. p. 573-607.Selected aspects of patent ductus arteriosus in the premature.

[39] Rao PS. Patent ductus arteriosus. In: Rao PS, editor. Pediatric cardiology: how it has evolved over the last 50 years. New Castle upon Tyne, UK: Cambridge Scholars Publishing; 2020. p. 387-451.

[40] Rao P,Chen S.Effectiveness of five-loop coils to occlude patent ductus arteriosus.Am J Cardiol1997;80:1498-501

[41] Rao P,Sideris EB.Transcatheter closure of patent ductus arteriosus with buttoned device: first successful clinical application in a child.Am Heart J1991;121:1799-802

[42] Rao PS. Echocardiographic evaluation of neonates with suspected heart disease. In: Rao PS, Vidyasagar D, editors. Perinatal cardiology: a multidisciplinary approach. Minneapolis, MN: Cardiotext Publishing; 2015.

[43] Jureidini SB,Rao PS.Congenital coronary artery abnormalities.Indian J Pediatr1998;65:217-29

[44] Kawasaki T.Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children.Arerugi1967;16:178-222

[45] Gupta-Malhotra M.Current perspectives on Kawasaki disease.Indian J Pediatr2005;72:621-9 PMCID:PMC7091390

[46] Research Committee on Kawasaki Disease Report of subcommittee on standardization of diagnostic criteria and reporting of coronary artery lesions in Kawasaki disease. Tokyo, Japan: Ministry of Health and Welfare; 1984.

[47] Zorzi A, Colan SD, Gauvreau K, Baker AL, Sundel RP, Newburger JW. Coronary artery dimensions may be misclassified as normal in Kawasaki disease.J Pediatr1998;133:254-8

[48] Newburger JW,Gerber MA.Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart AssociationDiagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association.Pediatrics2004;114:1708-33

[49] McCrindle BW,Newburger JW.American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, and Council on Epidemiology and PreventionDiagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association.Circulation2017;135:e927-99