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Complete Echocardiographic Assessment of the Postoperative Fontan Patient
Author(s) -
HAGLER DONALD J.,
CORDES TIMOTHY M.
Publication year - 1995
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1995.tb00845.x
Subject(s) - medicine , cardiology , intracardiac injection , pulmonary artery , diastole , right ventricular hypertrophy , atrioventricular valve , radiology , hemodynamics , ventricle , blood pressure
Postoperative echocardiographic assessment of the Fontan patient should include both anatomical and physiological parameters. Anatomical features to be defined with two‐dimensional (2‐D) imaging should include a detailed demonstration of the atriopulmonary connection, the pulmonary arterial tree, and the pulmonary venous return. Color flow imaging should be included to provide visual clues for abnormal flow patterns to suggest obstruction or residual shunts. Intracardiac thrombi, pericardial, and pleural effusions should be excluded. Inadequate transthoracic images should mandate the use of transesophageal imaging to adequately detail the extracardiac anatomy and connections. Physiological parameters should include M‐mode and 2‐D studies to assess ventricular systolic function and the degrees of ventricular hypertrophy. Additionally, extensive pulsed Doppler examination should be performed to determine the systemic venous, pulmonary arterial, pulmonary venous, and atrioventricular (AV) valve inflow patterns. Significant information detailing abnormalities of pulmonary artery flow and ventricular diastolic function parameters can be obtained. Doppler color flow imaging should be obtained to assess competency of AV and semilunar valves. Continuous‐wave Doppler should be utilized to determine the presence and severity of aortic outflow obstruction. Complete echocardiographic evaluation should include all facets of echocardiographic study as detailed previously.