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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3677_Библиотеки_им_академика_М_И_Перельмана
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Abbreviations
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AAo/AAO Ascending aorta
ADO II Amplatzer Duct Occluder II
ADO Amplatzer Duct Occluder
ALVT Aorta to left ventricular tunnel
Ao/AO Aorta
AR Aortic regurgitation
ASD Atrial septal defect
ASO Aterial swith operation
AV Aortic valve
BAS Balloon atrial septostomy
C Catheter
CA Common atrium
CAVC Complete atrioventricular canal
ccTGA Congenitally Corrected TGA
CHD Congenital heart diseases
CoA Coractation of aorta
CPB Cardiopulmonary bypass
CSO Coronary sinus ostium
CT Computed tomography
DAo/DAO Descending aorta
DCRV Double chambered right ventricle
DILV Double inlet left ventricle
DIRV Double inlet right ventricle
DORV Double outlet right ventricle
ECMO Extracorporeal Membrane Oxygeneation
HLHS Hypoplastic left heart syndrome
IA rim Anterior inferior rim
IAA Interrupted aortic arch
IAS Interatrial septum
IP rim Posterior inferior rim
IVS Interventricular septum
LA Left atrium
LAA Left atrial appendage
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LAI Left atrial isomerism
LAX Long-axis view
LB Left bronchus
LCC Left coronary cusp
LD Left Disc
LPA Left pulmonary artery
LV Left ventricle
LVOT Left ventricular outow tract
ME LAX Mid-esophageal long axis view
ME SAX Mid-esophageal short axis view
MPR Multiplanar reformatting
MV Mitral valve
NCC Noncoronary cusp
O Occulder
PA Pulmonary artery
PAPVC Partial anomalous pulmonary venous connection
PDA Patent ductus arteriosus
pmVSD Perimembranous ventricular septal defect
PV Pulmonary valve
RA Right atrium
RAA Right atrial appendage
RAI Right atrial isomerism
RB Right bronchus
RCA Right coronary artery
RCAA Right coronary artery aneurysm
RCC Right coronary cusp
RD Right Disc
RPA Right pulmonary artery
RSVA Ruptured sinus of Valsalva Aneurysm
RUPV Right upper pulmonary vein
RV Right ventricle
RVOT Right ventricular outow tract
SA rim Anterior superior rim
SAX Short-axis view
SP rim Superior posterior rim
SVASD Sinus Venous ASD
TA Tricuspid atresia
TAPVC Total anomalous pulmonary venous connection
TEE Transesophageal echocardiography
TG Transgastric view
TGA Transposition of the great arteries
TOF Tetralogy of Fallot
TPV Transcatheter pulmonary valve
Abbreviations
Abbreviations
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T Trachea
TrA Truncus arteriosus
TV Tricuspid valve
UE LAX Upper-esophageal long axis view
UE SAX Upper-esophageal short axis view
VSD Ventricular septal defect
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Part I
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Introduction of Transesophageal
Echocardiography (TEE) for Pediatric
Congenital Heart Diseases
Overview ofPediatric Echocardiography
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Echocardiography is an imaging method that uses ultrasound waves to visualize the
heart’s structures and functions. Pediatric echocardiography [1–4] has a history that
dates back to the 1950s, when ultrasound imaging was rst developed for medical
applications. However, it was not until the 1970s that two-dimensional (2D) echocardiography became a widely available diagnostic tool for pediatric use. Dr. Helen
Taussig, a renowned pediatric cardiologist known for developing the BlalockTaussig shunt, recognized the potential of echocardiography as a diagnostic tool and
worked with engineers and scientists to create the rst pediatric echocardiography
machine. Over time, technological advancements led to the development of more
sophisticated imaging techniques. Nowadays, pediatric echocardiography [5, 6] is
widely used in diagnosing and managing congenital and acquired heart disease in
infants and children (as shown in Fig.1.1).
Transthoracic echocardiography (TTE) is one of the techniques that involves
placing a transducer on the chest to create images of the heart from outside the body.
The choice of transducer used in pediatric TTE echocardiography depends on the
child’s age and size. Smaller transducers with higher frequencies are typically used
for newborns and young infants to obtain clear images, while larger transducers
with low frequency may be required for deeper structures as children grow and their
chest size increases.
M-mode echocardiography [7, 8] which is a common mode in TTE was rst
developed in the 1950s as a diagnostic tool for cardiology. This technique is allowed
for the production of high-frequency sound waves that could be focused and directed
to produce detailed images of internal structures. Initially, M-mode echocardiography was used to measure the thickness of heart walls and assess cardiac function in
adults with heart disease (as shown in Fig.1.2). Today, M-mode echocardiography
is often used in pediatric cardiology to monitor heart function, and assess response
to therapy.
1
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023
S.-K. Tsai et al., Transesophageal Echocardiography in Pediatric Congenital Cardiac
Surgery and Catheter Intervention, https://doi.org/10.1007/978-981-99-6582-3_1
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4
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1 Overview ofPediatric Echocardiography
a
b
Fig. 1.1 Transthoracic echocardiography (TTE) depicts a secundum atrial septal defect (ASD)
and a superior sinus venous ASD in a child. (a) A TTE taken from the subxiphoid short-axis view
displays a large secundum atrial septal defect (ASD) measuring 2.03cm in diameter. The right
diagram, using color Doppler, demonstrates a left-to-right shunt. (b) A TTE taken from the subxiphoid short-axis view reveals that blood ow drains from the superior vena cava (SVC) into the left
atrium (LA), indicating a superior sinus venous atrial septal defect (ASD) measuring 1.66cm in
diameter. The right diagram, using color Doppler, demonstrates a left-to-right shunt
1 Overview ofPediatric Echocardiography
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Fig. 1.2 Depicts an M-mode echocardiogram image that illustrates right ventricular volume overload in a child who has undergone surgery for tetralogy of Fallot, with severe pulmonary regurgitation. The image demonstrates paradoxical motion, which indicates dilation of the right ventricle
5
Color Doppler echocardiography [9, 10], which utilizes Doppler technology to
generate a color-coded image of blood ow and velocities, was initially introduced
in the mid-1980s. This technology enabled a more in-depth assessment of blood
ow patterns and velocities in the heart and surrounding vessels (as shown in
Fig.1.1 right diagram). Nowadays, it is a fundamental component of most echocardiography systems.
The development of intracardiac echocardiography (ICE) technology began in
the 1980s, and the rst clinical applications of ICE were reported in the early 1990s.
This technology involves the insertion of a small ultrasound probe into the heart
through a catheter sheath, typically introduced from the femoral vein into the right
atrium. Once the probe is inside the heart, it provides high-resolution real-time
images of the heart structures (as depicted in Fig.1.3). ICE [11, 12] has emerged as
a crucial tool in the diagnosis and management of various cardiac conditions,
including arrhythmias, valvular heart disease, and congenital heart defects (as
shown in Fig.1.3).
Transesophageal echocardiography (TEE) is another kind of echocardiography
that is performed by passing a exible probe (transducer) through the mouth and
into the esophagus, which is located behind the heart. The transducer emits
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Fig. 1.3 Demonstrates the
use of intracardiac
echocardiography (ICE)
for detecting a secundum
atrial septal defect (ASD
II). The color Doppler
image shows a left-to-right
shunt during the
transcatheter closure of
the ASD
1 Overview ofPediatric Echocardiography
ultrasound waves that bounce back from the heart and are then converted into
images that can be viewed on a monitor. TEE may provide a more detailed view of
the heart than TTE and will be further discussed in Chap. 2.
The inception of 3D echocardiography [13–15] dates back to the 1970s, with its
rst clinical application in adults reported in 1974. Nevertheless, it was not until the
1990s that 3D echocardiography became commercially available and commonly
used in clinical practice (as shown in Fig.1.4).
4D echocardiography [16, 17], which includes the time dimension in 3D images,
was developed in the 2000s. These advanced imaging techniques offer more intricate information on the structures and functions of the heart than conventional 2D
echocardiography, and they are especially helpful in visualizing complex cardiac
structures (as shown in Figs. 8.34b1 and 9.4).
Advancements in pediatric cardiac imaging have posed signicant challenges
due to the intricate nature of pediatric heart disease and its growth-related impact.
However, the use of articial intelligence [18, 19] (AI) in pediatric echocardiography has the potential to enhance the quality, interpretation, and clinical application
of echocardiographic data for sonographers, echocardiographers, and clinicians.
The echocardiogram is the primary imaging modality utilized by cardiologists.
With AI in medical imaging, we can expand the usefulness of cardiac ultrasounds
beyond their immediate observations, uncovering previously undetected patterns
and enabling more accurate and efcient diagnoses.
ab
References
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Fig. 1.4 Shows a three-dimensional (3D) echocardiogram of an unroofed coronary sinus (CS)
atrial septal defect (ASD) in a 5-year-old child who underwent transcatheter closure using an
occluder. (a) En face views of the atrium and aorta were obtained using 3D full volume cropping
with Philips QLab. The images clearly show a defect between the coronary sinus (CS) and the left
atrium (LA). A star indicated the ostium of the CS. (b) Successful transcatheter closure of the
ostium of CS using an occluder was demonstrated
7
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1 Overview ofPediatric Echocardiography
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