Dilated Coronary Sinus Echocardiogram

ME long axis

Vsd Surgery Recovery

Fig. 27. Tetralogy of fallot. Midesophageal four-chamber views (A,B) obtained from a 51-yr-old male with TOF with previous palliative surgery show a significant residual VSD (arrows) with left-to-right shunt. Note the moderate dilation of right cardiac chambers. Midesophageal long-axis views of the same VSD (arrows, C,D). (Please see companion DVD for corresponding video.)

Dilated Right Ventricle Septal Bowing

Fig. 28. Tetralogy of fallot. Midesophageal views showing residual stenosis/restenosis (arrow, A) of right ventricular outflow tract. Note the dilated right chambers and prolapsed septal leaflet of the tricuspid valve (arrow, B). A small jet from a PFO (arrow, C) confirmed by agitated saline contrast (D) was present. An additional defect, e.g., a PFO or an ASD present in patients with the tetralogy.

Fig. 28. Tetralogy of fallot. Midesophageal views showing residual stenosis/restenosis (arrow, A) of right ventricular outflow tract. Note the dilated right chambers and prolapsed septal leaflet of the tricuspid valve (arrow, B). A small jet from a PFO (arrow, C) confirmed by agitated saline contrast (D) was present. An additional defect, e.g., a PFO or an ASD present in patients with the tetralogy.

Tetralogy Fallot Gore Tex

Fig. 29. Palliative surgery to increase pulmonary blood flow: modified Blalock-Taussig (BT) shunt. The modified BT shunt is an aorta-to-right pulmonary artery shunt using a Gore-Tex shunt (the original "classic BT shunt" was a right subclavian-to-right pulmonary artery shunt). These shunts may distort the pulmonary artery; they may stenose, occlude, or develop aneurysms.

Modified Bialock-Taussig Shunt (palliation)

Fig. 29. Palliative surgery to increase pulmonary blood flow: modified Blalock-Taussig (BT) shunt. The modified BT shunt is an aorta-to-right pulmonary artery shunt using a Gore-Tex shunt (the original "classic BT shunt" was a right subclavian-to-right pulmonary artery shunt). These shunts may distort the pulmonary artery; they may stenose, occlude, or develop aneurysms.

Tetralogy Fallot Surgery

Fig. 30. Tetralogy of fallot: corrective surgery with VSD closure and right ventricular outflow tract (RVOT) surgery.

Corrective Repair

Fig. 30. Tetralogy of fallot: corrective surgery with VSD closure and right ventricular outflow tract (RVOT) surgery.

Ebstein Anomaly EchocardiogramTetralogy Fallot Surgery

Fig. 31. Ebstein's malformation. Characteristic features of this anomaly are shown the huge right atrium—the apical portion actually an "atrialized" portion of the right ventricle—labeled (ARV) (A-D). Note the "sail-like" anterior tricuspid leaflet in this parasternal short-axis view (D). (Please see companion DVD for corresponding video.)

Fig. 31. Ebstein's malformation. Characteristic features of this anomaly are shown the huge right atrium—the apical portion actually an "atrialized" portion of the right ventricle—labeled (ARV) (A-D). Note the "sail-like" anterior tricuspid leaflet in this parasternal short-axis view (D). (Please see companion DVD for corresponding video.)

Dysfunction
Fig. 32. Ebstein's malformation. The low peak tricuspid regurgitation velocities seen on CW Doppler (<1.2 m/s) in this patient with Ebstein's anomaly are a reflection of right ventricular dysfunction.
Proximal Ventricular Wall
Fig. 33. Ebstein's malformation. Fusion of the tricuspid leaflets to the ventricular wall distally within the RV cavity leads to "atrial-ization" of the proximal RV segment, diminution in size of the distal RV.
Tga Echocardiography Senning

Fig. 34. Corrected D-transposition by arterial switch (Jatene). These exercise stress echocardiography images in this patient with D-TGA shows a rather normal looking parasternal long-axis (PLAX) View. The "Ao" is the neo-aorta is the former pulmonary trunk. This permits the morphologic LV to remain the systemic ventricle. Switch at the arterial level (compared to the switch at the atrial level—Mustard and Senning procedures) results in less long-term ventricular dysfunction. Periodic exercise stress testing to evaluate possible coronary ischemia is recommended, as reimplantation of coronary arteries is an integral part of the arterial switch operation.

Fig. 34. Corrected D-transposition by arterial switch (Jatene). These exercise stress echocardiography images in this patient with D-TGA shows a rather normal looking parasternal long-axis (PLAX) View. The "Ao" is the neo-aorta is the former pulmonary trunk. This permits the morphologic LV to remain the systemic ventricle. Switch at the arterial level (compared to the switch at the atrial level—Mustard and Senning procedures) results in less long-term ventricular dysfunction. Periodic exercise stress testing to evaluate possible coronary ischemia is recommended, as reimplantation of coronary arteries is an integral part of the arterial switch operation.

Left Persistent Svc Echo

Fig. 35. The presence of a markedly dilated coronary sinus (arrows in all panels) in an otherwise normal heart should trigger consideration of a persistent left superior vena cava that empties directly into the coronary sinus. It has no pathological sequelae. Agitated saline contrast injected into the left arm will opacify the coronary sinus before the right atrium. Injecting contrast into the right arm would opacify the right atrium only.

Fig. 35. The presence of a markedly dilated coronary sinus (arrows in all panels) in an otherwise normal heart should trigger consideration of a persistent left superior vena cava that empties directly into the coronary sinus. It has no pathological sequelae. Agitated saline contrast injected into the left arm will opacify the coronary sinus before the right atrium. Injecting contrast into the right arm would opacify the right atrium only.

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Responses

  • lena
    Where is dialted coronary sinus located on an echo?
    10 months ago
  • ubalda
    Why do dogs with normal echo have dilated coronary arteries?
    8 months ago
  • arabella
    What is enlarged coronary sinus?
    3 months ago

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