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Evolution of echocardiography in adult congenital heart disease: from pulsed-wave Doppler to fusion imaging

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Abstract

The number of patients with adult congenital heart disease (ACHD) has been dramatically increasing and adults with congenital heart disease now outnumber children with congenital heart disease. However, patients with ACHD are still at increased risk of morbidity and mortality due to residua and sequelae. Although echocardiography is an indispensable imaging modality in the comprehensive assessment of ACHD, accurate echocardiographic assessment of ACHD is challenging especially for physicians or sonographers who are not familiar with ACHD because of its complex morphology, physiology, and hemodynamics. A recently developed fusion imaging technology can provide synchronized display of real-time echocardiographic images and multiplanar reconstruction images of computed tomography or magnetic resonance imaging corresponding to the image plane of real-time echocardiography. We have reported the clinical utility of this fusion imaging technology for the precise evaluation of complex ACHD. On the other hand, conventional echocardiographic technology also plays an important role in assessing unique ACHD pathophysiology. For example, restrictive right ventricular physiology is a common finding after tetralogy of Fallot or pulmonary stenosis repair and can be evaluated by conventional pulsed-wave Doppler. In this review, we discuss the clinical usefulness of modern and conventional echocardiographic technologies for the evaluation of ACHD by presenting a case series.

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Abbreviations

ACHD:

Adult congenital heart disease

ccTGA:

Congenitally corrected transposition of great arteries

CHD:

Congenital heart disease

CT:

Computed tomography

EDFF:

End-diastolic forward flow

LVOT:

Left ventricular outflow tract

MRI:

Magnetic resonance imaging

PA:

Pulmonary artery

PR:

Pulmonary regurgitation

PVR:

Pulmonary valve replacement

RV:

Right ventricle / ventricular

TOF:

Tetralogy of Fallot

TTE:

Transthoracic echocardiography

VSD:

Ventricular septal defect

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Acknowledgements

The authors thank Nobuhisa Watanabe, RDCS for obtaining the excellent echocardiographic data.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Adult Congenital Heart Disease Center, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan

    Norihisa Toh, Teiji Akagi & Hiroshi Ito

  2. Department of Cardiovascular Surgery, Adult Congenital Heart Disease Center, Okayama University Hospital, Okayama, Japan

    Shingo Kasahara

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  1. Norihisa Toh
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  2. Teiji Akagi
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  4. Hiroshi Ito
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Correspondence to Norihisa Toh.

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Norihisa Toh received lecture fees from Canon Medical Systems Corporation.

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Toh, N., Akagi, T., Kasahara, S. et al. Evolution of echocardiography in adult congenital heart disease: from pulsed-wave Doppler to fusion imaging. J Echocardiogr 19, 205–211 (2021). https://doi.org/10.1007/s12574-021-00533-w

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  • DOI: https://doi.org/10.1007/s12574-021-00533-w

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