Faculty Bibliography

To determine the capacity of the left ventricle to expand after biventricular repair of left ventricular (LV) outflow tract obstruction, we studied pre- and postoperative echocardiographic variables from 14 infants (< 2 months old) who underwent successful repair of isolated aortic coarctation. We show that in this lesion, LV volume is a dynamic entity, and that the left ventricle achieves a larger cavity size once surgery relieves compression and normalizes loading conditions

We assessed how well transesophageal echocardiography (TEE) images the left pulmonary artery (LPA) in congenital heart disease (CHD). Seventy-nine consecutive patients with CHD were studied. Ideal imaging displayed the mid to distal LPA from the takeoff of the upper lobe artery through the second bifurcation. Imaging quality was graded from 1 (excellent) to 5 (not visualized). Imaging quality was excellent in 8 (10%) patients, good in 25 (32%), fair in 23 (29%), and poor in 12 (15%); the LPA was not visualized in 11 (14%) patients. Imaging grade averaged 2.9 +/- 1.2 (SD) and correlated poorly with weight (r = 0.24) but was better in patients without prior operation (grade 2.8 vs 3.3, P <.05). In 2 patients, TEE showed residual stenosis. Thus informative LPA imaging by TEE can be achieved in many patients with CHD and has the potential to change intraoperative or postoperative treatment

Echocardiography is an extraordinarily useful imaging technique in fetuses, infants, children, and adolescents. Recent technologic innovations have expanded its versatility in the pediatric population. However, limited societal resources, limitations inherent to ultrasound imaging, and numerous imaging options even within the field of pediatric echocardiography necessitate the discriminate and thoughtful use of echocardiography in children. The clinical assessment remains a critical prelude to echocardiographic examination of the pediatric cardiovascular system