Circulation, Vol 59, 513-524, Copyright © 1979 by American Heart Association
LW Lange, DJ Sahn, HD Allen and SJ Goldberg
We developed anatomically related cross-sectional echocardiographic views
to image the heart from the subxiphoid area in 100 children and infants
with various forms of congenital heart disease studied prospectively before
cardiac catheterization. Wide-angle cross- sectional views were achieved
using a mechanical sector scanner in a scan plane oriented parallel to a
line between the patient's shoulders (a coronal plane) showing the
equivalent anatomy of an anteroposterior angiogram. The subxiphoid
technique appeared to be better than chest wall-based imaging in
demonstrating obstructive lesions in the proximal portion of the right
ventricular outflow tract (19 patients), i.e., the subpulmonic area, which
is often at the narrow edge of the sector and behind the transducer
artifact in chest wall studies. The subxiphoid technique was also useful
for imaging the interatrial and interventricular septae; in subxiphoid
views, as opposed to four- chamber apical views, there was significantly
less false septal dropout and atrial septal defects (19 patients) as well
as ventricular septal aneurysms (seven patients) were easily imaged.
Finally, the subxiphoid orientation provided more adequate imaging in
patients with discrete diaphragmatic subaortic stenosis (four patients),
even when the diaphragm was just beneath the aortic valve. Subxiphoid
cross-sectional echocardiography is an easily understood anatomical format
for imaging cross-sectional anatomy in congenital heart disease and is a
valuable adjunct to cross-sectional echocardiography from the chest wall.
ARTICLES
Subxiphoid cross-sectional echocardiography in infants and children with congenital heart disease