Echocardiography in the Management of Single Ventricle:

Echocardiography contributes to the management of patients with single ventricle by providing an initial comprehensive evaluation in fetal and neonatal life. This allows planning of the initial surgical palliation, usually without the need for cardiac catheterization. Serial surveillance for problems such as subaortic stenosis, valvar insufficiency, or complications of the mitral palliation aids in planning for the timing and type of subsequent surgical procedures. Evaluation of single ventricle size, shape, and mass provides some indication of risk for a Fontan procedure. Transesophageal echocardiography provides an excellent window for the evaluation of the interatrial baffle for shunts, thrombi, or occlusion in the early postoperative period. Later, studies of ventricular and valve function help to direct medical management such as afterload reduction and diuretic therapy.