DK2985_C000 1..28 - AlSharqia Echo Club

Congenital Heart Disease 537(A)(B)LVLARVAoVVSDFigure 24.16 Mid-esophageal long-axis view showing a large nonrestrictive membranous ventricular septal defect (VSD) (AoV,aortic valve; LA, left atrium; LV, left ventricle; RV, right ventricle).communication is large and nonrestrictive, massiveshunting leads to pulmonary hypertension, obstructive pulmonaryvascular disease, and early heart failure, requiringsurgical repair. On the other hand, when the VSD is smallor absent as in the partial form with only an interatrialcommunication resulting in an ostium primum ASD anda cleft anterior mitral leaflet (Fig. 24.12), the diagnosis issometimes made at an older age.TEE in Atrioventricular Septal Defect (Table 24.2)The echocardiographic evaluation should focus on thefollowing points: the type and extent of intracardiac shunting,the atrioventricular valve morphology, assessment ofthe commitment of the atrioventricular junction to theunderlying ventricular myocardium, assessment of ventricularsize (in certain cases, the ventricles are unequal in(A)(B)VSDRVLVRALA(C)VSDFigure 24.17 Trabecular muscular ventricular septal defect (VSD). (A, B) Deep transgastric view, showing a left-to-right shunt on thecolor Doppler examination. (C) Intraoperative findings (LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle).