Euroecho2010 non-cyanotic-disease
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BEST OF EUROECHO 2010. destiné pour DEMSISTS...bon courage
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Euroecho2010 non-cyanotic-disease
- 1. Non cyanotic Congenital heart diseases C Bussadori (Milano,IT) Department of Pediatric Cardiology and Adult with Congenital Heart Disease p gy g IRCCS- Policlinico San Donato San Donato Milanese – Milano Italy EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 2. ASD Ostium secundum The Most Common atrial septal defect – Various size – Parasternal Short axis – Subcostal view • Suboptimal in adults EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 3. ASD Ostium secundum The Most Common atrial septal defect – Modified apical 4 ch – Various size – CFD • Beware to high RA pressure EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 4. ASD Ostium secundum The Most Common atrial septal defect It seem circular but often it isn’t – Measure from different views and consider the largest – 3D it helps – TEE 2D or 3D offer ultimate sizing for ASD and rim diameters EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 5. ASD Ostium secundum The Most Common atrial septal defect It seem circular but often it isn’t – TEE 2D or 3D offer ultimate information on ASD and rims shape and dimension EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 6. ASD Differential Diagnosis: OS 1 Partial AV septal defect AV valve at the same level: MR, goose neck deformity of LVOT Post Surgical Complication: SAS Complete AV block S gical Complication SAS, EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 7. ASD Differential Diagnosis: Sinus Venous Defects • Difficult to diagnose by TTE • Modified parasternal • Subcostal • Often associate to Anomalous pulmonary venous drainage EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 8. Ventricular septal defect • Perimembranous – Various estension • Muscular –I l Inlet, O l Outlet, apical i l trabecular – Doubly committed Subarterial EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 9. Perimembranous VSD EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 10. Perimembranous VSD TTE TEE EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 11. Perimembranous VSD 2D TEE 3D TEE EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 12. Perimembranous VSD EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 13. Perimembranous VSD EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 14. Perimembranous VSD EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 15. Muscular VSD •Apical Trabecular Apical •4 chamber •Muscular Inlet •Short Axis •Multiple VSD M lti l •3D EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 16. Doubly committed Subarterial Fibrous continuty between aortic and pulmonary valves EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 17. PDA • Most of adult cases of PDA are small and silent • Parasternal short axis view • CFM Demonstrate L to R Shunt from PDA to Sh t f t MPA • CW Doppler reflects PA pressure EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 18. Aortic coarctation • Between left subclavian and arterial duct • Frequently assoc ated to eque t y associated • PDA, VSD, Ao.Bic. • Modified Bernoulli formula • (ΔP=4(v (ΔP 4( 22 – v12)) • CW peack gradient. Mean Gradient • PW abdominal aorta V1 V2 EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 19. Aortic bicuspidia p EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 20. Aortic bicuspidia EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 21. Aortic regurgitation EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 22. Sinus of Valsalva Perforation
- 23. Pulmonic Stenosis Various Morphology *Milo S Heart 1988;60:128-133 80% are dome shaped p
- 24. Pulmonic stenosis EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 25. Pulmonic stenosis EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010
- 26. PS “hour-glass”
- 27. Take home a message g • Non cyanotic CHD could be an unexpected y p diagnosis in an adult cardiac patient • Recognize the anatomical features and pathophysiological changes t suggest th h i l i l h to t appropriate treatment and Follow UP EUROECHO CONGRESS - COPENHAGEN - TEACHING COURSE 2010