Echocardiographic study of the morphology and growth of the aortic arch in the human fetus. Observations related to the prenatal diagnosis of coarctation.

Background: In a study of normal and abnormal growth of the aorta before birth, high-resolution echocardiographic imaging of the aortic arch in 92 normal fetuses aged 16-38 weeks was used to establish normal values for aortic arch dimensions at varying gestational ages.

Methods And Results: From long-axis views of the aortic arch, the internal diameter of the aortic root, ascending aorta, transverse aortic arch, aortic isthmus, proximal descending thoracic aorta, and left common carotid artery were measured. Correlation coefficients for the diameter of each aortic arch segment when related to gestational age varied from r = 0.

A new method for noninvasive estimation of ventricular septal defect shunt flow by Doppler color flow mapping: imaging of the laminar flow convergence region on the left septal surface.

An accurate but simple and noninvasive method for quantifying flow across a ventricular septal defect has yet to be implemented for routine clinical use. A region of flow convergence is commonly imaged by Doppler color flow mapping on the left septal surface of the ventricular septal defect, appearing as a narrowed region of laminar flow with aliased flow velocities entering the orifice. If the first aliasing region represents a hemispheric isovelocity boundary of a surface of flow convergence and all flow at this surface crosses the ventricular septal defect, the flow through the defect can be estimated by using the radius (R), measured from the first alias to the orifice, and the Nyquist limit (NL) velocity (the flow velocity at the first alias).

Transvascular intracardiac applications of a miniaturized phased-array ultrasonic endoscope. Initial experience with intracardiac imaging in piglets.

Background: Recent advances in miniaturization of phased-array and mechanical ultrasound devices have resulted in exploration of alternative approaches to cardiac and vascular imaging in the form of transesophageal or intravascular imaging. Preliminary efforts in adapting phased-array endoscopes designed for transesophageal use to a transvascular approach have used full-sized phased-array devices introduced directly into the right atrium in open-chested animals. The purpose of this study was to assess the feasibility of using a custom-made, very small phased-array endoscope for intracardiac imaging introduced intravascularly through a jugular venous approach in young piglets.

Noninvasive Doppler color flow mapping for detection of anomalous origin of the left coronary artery from the pulmonary artery and for evaluation of surgical repair.

Anomalous origin of the left coronary artery from the pulmonary artery is a rare but important cause of congestive heart failure in infancy and of sudden death at all ages. Diagnosis is often missed when based solely on physical examination and noninvasive methods. A 4 year old patient is presented in whom mitral regurgitation was noted by a referring physician and an anomalous left coronary artery was found by Doppler color flow mapping upon referral and verified at cardiac catheterization.