Echocardiography

Echocardiographic techniques have revolutionized the practice of congenital cardiology over the last three decades. Due to its non-invasive nature and high temporal resolution, echocardiography enables cardiac structures to be imaged as early as the 14th gestational week and it remains the superior diagnostic modality in small children. While transoesophageal (TOE) two-dimensional echocardiography has become an integral part of almost all cardiac interventions, real-time three-dimensional TOE used in older children and adults may help surgeons to understand dynamic spatial relationships of intracardiac structures, enabling them to achieve the best result of an operation. Post bypass, two- and three-dimensional TOE studies significantly reduce the number of reoperations, unnecessary bypass procedures, and general anaesthetics. A developing technique known as tissue deformation imaging enables the assessment of global and regional myocardial systolic and diastolic function even in small hearts. Although mainly used for research, in some specific situations these techniques may modify further diagnostic management, optimize medication, or even change clinical management. Despite its known limitations, echocardiography remains a routine imaging modality for all patients with congenital heart disease, being a definitive imaging modality prior to intervention for many children and screening imaging for older children and adults with congenital heart disease.