Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult

796 Pages·2009·94.25 MB·English

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Echocardiography in Pediatric and Congenital
Heart Disease
Echocardiography in Pediatric and Congenital Heart Disease: From Fetus to Adult
Edited by Wyman W. Lai, Luc L. Mertens, Meryl S. Cohen and Tal Geva
© 2009 Blackwell Publishing Ltd. ISBN: 978-1-405-17401-5
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Video clips on DVD-ROM
This book is accompanied by a DVD with over 300 video clipsshowing anatomy
and conditions described in the text.
• All the clips are fully referenced in the text, where you see this symbol:
• The database of videos is fully searchable.
• The DVD is suitable for PC and Mac computers.
Additional supplementary video clips are also available on a companion website
for downloading at:
www.wiley.com/go/lai/echocardiography
9781405174015_1_pre.qxd 7/10/09 10:40 AM Page iii
Echocardiography in
Pediatric and
Congenital Heart
Disease
From Fetus to Adult
EDITED BY
Wyman W. Lai, MD, MPH
Director, Non-Invasive Cardiac Imaging
Division of Pediatric Cardiology
Morgan Stanley Children’s Hospital of New York Presbyterian
New York, NY, USA
Luc L. Mertens, MD, PhD
Section Head, Echocardiography
The Hospital for Sick Children
Associate Professor of Pediatrics
University of Toronto
Toronto, ON, Canada
Meryl S. Cohen, MD
Associate Professor of Pediatrics
University of Pennsylvania School of Medicine;
Director, Echocardiography Laboratory
Co-Director, Cardiology Fellowship Training Program
The Children’s Hospital of Philadelphia
Philadelphia, PA, USA
Tal Geva, MD
Professor of Pediatrics
Harvard Medical School;
Chief, Division of Non-Invasive Cardiac Imaging
Department of Cardiology
Children’s Hospital Boston
Boston, MA, USA
A John Wiley & Sons, Ltd., Publication
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This edition first published 2009, © 2009 by Blackwell Publishing Ltd
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Library of Congress Cataloging-in-Publication Data
Echocardiography in pediatric and congenital heart disease : from fetus to adult / [edited by] Wyman Lai...[et al.].
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4051-7401-5 (alk. paper)
1. Electrocardiography. 2. Congenital heart disease. 3. Congenital heart disease in children.
4. Pediatric cardiology. I. Lai, Wyman.
[DNLM: 1. Echocardiography—methods. 2. Heart Defects, Congenital—diagnosis. WG 141.5.E2 E186 2009]
RC683.5.E5E258 2009
616.1’207547—dc22
2009013413
ISBN: 978-1-4051-7401-5
A catalogue record for this book is available from the British Library.
Set in 9/12pt Meridien by Graphicraft Limited, Hong Kong
Printed and bound in Singapore
01 2009
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Contents
List of Contributors vii 10. Systemic Venous Anomalies 143
Preface xi Leo Lopez and James C. Huhta
11. Anomalies of the Atrial Septum 158
Tal Geva
Part 1 Introduction to Cardiac
Ultrasound Imaging 12. Anomalies of the Ventricular Septum 175
Geoffrey A. Forbus and Girish S. Shirali
1. Ultrasound Physics 3
13. Tricuspid Valve and Right Atrial Anomalies 188
Piet Claus and Jan D’hooge
Ulrike E. Salzer-Muhar
2. Laboratory Function, Instrumentation, Patient
14. Mitral Valve and Left Atrial Anomalies 214
Preparation and Patient Safety 15
James C. Nielsen and Sharon E. O’Brien
Richard A. Humes
15. Common Atrioventricular Canal Defects 230
3. Nomenclature and Segmental Approach to
Meryl S. Cohen
Congenital Heart Disease 22
Tal Geva
4. The Normal Pediatric Echocardiogram 34 Part 4 Anomalies of the Ventriculoarterial
Wyman W. Lai and H. Helen Ko Junction and Great Arteries
16. Anomalies of the Right Ventricular Outflow
Part 2 Quantitative Methods Tract and Pulmonary Valve 251
Matthew S. Lemler and Claudio Ramaciotti
5. Structural Measurements and Adjustment
17. Pulmonary Atresia with Intact Ventricular
for Growth 53
Thierry Sluysmans and Steven D. Colan Septum 264
Jami C. Levine
6. Hemodynamic Measurements 63
Steven D. Colan 18. Abnormalities of the Ductus Arteriosus and
Pulmonary Arteries 283
7. Echocardiographic Evaluation of Systolic
Theresa A. Tacy
Function 76
Luc L. Mertens, Javier Ganame and 19. Anomalies of the Left Ventricular Outflow
Bénédicte Eyskens Tract and Aortic Valve 297
John M. Simpson
8. Diastolic Ventricular Function Assessment 95
Peter C. Frommelt 20. Hypoplastic Left Heart Syndrome 315
David J. Goldberg and Jack Rychik
21. Aortic Arch Anomalies: Coarctation of the
Part 3 Anomalies of the Systemic and
Aorta and Interrupted Aortic Arch 339
Pulmonary Veins, Septa and
Jan Marek, Matthew Fenton and Sachin
Atrioventricular Junction
Khambadkone
9. Pulmonary Venous Anomalies 119 22. Tetralogy of Fallot 362
David W. Brown Shubhika Srivastava and Ira A. Parness
v
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Contents
23. Truncus Arteriosus 385 35. Restrictive Cardiomyopathy and Pericardial
Mark B. Lewin and Jack C. Salerno Disease 597
Cecile Tissot, Christina Phelps and Adel K. Younoszai
24. Transposition of the Great Arteries 398
Luc L. Mertens, Manfred Otto Vogt, Jan Marek and 36. Other Anomalies of the Ventricular Myocardium 619
Meryl S. Cohen Mary Etta E. King
25. Double-Outlet Ventricle 417
Leo Lopez Part 7 Acquired Pediatric Heart Disease
26. Physiologically “Corrected” Transposition of
37. Kawasaki Disease 637
the Great Arteries 439
Erik C. Michelfelder
Erwin Oechslin
38. Rheumatic Fever 648
Luciana T. Young
Part 5 Miscellaneous Cardiovascular
39. Infective Endocarditis 657
Lesions
Manfred Otto Vogt
27. Functionally Univentricular Heart 459
Stéphane L.J. Moniotte and Catherine Barrea
Part 8 Special Techniques and Topics
28. Cardiac Malpositions and Heterotaxy Syndrome 476
Irene D. Lytrivi and Wyman W. Lai 40. Transesophageal Echocardiography 671
J. Geoffrey Stevenson
29. Congenital Anomalies of the Coronary Arteries 502
J. René Herlong 41. 3D Echocardiography 687
Folkert Jan Meijboom, Annemien van den Bosch
30. Vascular Rings and Slings 523
andJackie McGhie
Andrew J. Powell
42. Fetal Echocardiography 717
31. Connective Tissue Disorders 537
Lisa K. Hornberger
Julie De Backer, Ann De Paepe, Bart Loeys and
43. Vascular Ultrasound Imaging in Children 745
Harry C. Dietz
Elif Seda Selamet Tierney and Tajinder P. Singh
32. Cardiac Tumors 547
44. The Echocardiographic Assessment of
Michele A. Frommelt
Pulmonary Arterial Hypertension 754
Jeffrey F. Smallhorn
Part 6 Anomalies of Ventricular
Appendix 1: Normal Values for Cardiovascular
Myocardium
Structures 765
33. Dilated Cardiomyopathy and Myocarditis 559 Appendix 2: Echocardiography in Pediatric
Carolyn T. Spencer Disease States with Diastolic Dysfunction
Peter C. Frommelt [Available on the enclosed DVD-ROM]
34. Hypertrophic Cardiomyopathy 581
Colin J. McMahon and Javier Ganame Index 786
Video clips on DVD-ROM
This book is accompanied by a DVD with over 300 video clipsshowing anatomy
and conditions described in the text.
• All the clips are fully referenced in the text, where you see this symbol:
• The database of videos is fully searchable.
• The DVD is suitable for PC and Mac computers.
Additional supplementary video clips are also available on a companion website
for downloading at:
www.wiley.com/go/lai/echocardiography
vi
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List of Contributors
Catherine Barrea MD Julie De Backer MD, PhD Geoffrey A. Forbus MD
Assistant Professor Senior Clinical Investigator (Cardiology and Assistant Professor of Pediatrics
University of Louvain Medical School; Medical Genetics) Medical University of South Carolina;
Staff Physician Ghent University; Director, Pediatric Cardiology Outpatient Clinics
Pediatric Cardiology Head of Clinic, Cardiology Medical University of South Carolina
Cliniques Universitaires Saint-Luc University Hospital Ghent Charleston, SC, USA
Brussels, Belgium Ghent, Belgium
Michele A. Frommelt MD
Annemien van den Bosch MD, PhD Ann De Paepe MD, PhD
Associate Professor of Pediatrics
Erasmus MC Rotterdam Professor in Medical Genetics
Division of Pediatric Cardiology
Department of Cardiology; Ghent University;
Medical College of Wisconsin;
Cardiologist in Training Head of Department of Medical Genetics
Director of Fetal Echocardiography
Erasmus MC Rotterdam – Thoraxcenter University Hospital Ghent
Children’s Hospital of Wisconsin
Department of Cardiology Ghent, Belgium
Milwaukee, WI, USA
Rotterdam, The Netherlands
Jan D’hooge PhD
David W. Brown MD Associate Professor Peter C. Frommelt MD
Assistant Professor of Pediatrics Division of Cardiovascular Imaging and Professor of Pediatrics
Harvard Medical School; Dynamics Medical College of Wisconsin;
Staff Physician Department of Cardiovascular Diseases Director of Echocardiography
Pediatric Cardiology Catholic University of Leuven; Children’s Hospital of Wisconsin
Children’s Hospital Boston Medical Imaging Research Center Milwaukee, WI, USA
Boston, MA, USA University Hospital Gasthuisberg
Leuven, Belgium
Javier Ganame MD, PhD
Piet Claus PhD
Scientist
Post-Doctoral Researcher Harry C. Dietz MD University of Leuvens;
Division of Cardiovascular Imaging and Dynamics Victor A. McKusick Professor of Medicine and Staff Cardiologist
Department of Cardiovascular Diseases Genetics Department of Pediatric Cardiology
Catholic University of Leuven; Institute of Genetic Medicine University Hospitals Leuven
Medical Imaging Research Center Department of Pediatrics, Medicine and Molecular Leuven, Belgium
University Hospital Gasthuisberg Biology and Genetics;
Leuven, Belgium Investigator
Howard Hughes Medical Institute Tal Geva MD
Meryl S. Cohen MD Johns Hopkins University Professor of Pediatrics
School of Medicine Harvard Medical School;
Associate Professor of Pediatrics
Institute of Genetic Medicine Chief, Division of Non-Invasive Cardiac
University of Pennsylvania School of Medicine;
Baltimore, MD, USA Imaging
Director, Echocardiography Laboratory
Department of Cardiology
Co-Director, Cardiology Fellowship Training Program
The Children’s Hospital of Philadelphia Benedicte Eyskens MD, PhD Children’s Hospital Boston
Boston, MA, USA
Philadelphia, PA, USA Assistant Professor of Paediatrics
University of Leuven
Steven D. Colan MD Leuven, Belgium David J. Goldberg MD
Professor of Pediatrics Assistant Professor
Harvard Medical School; Matthew Fenton MB, BS, BSc University of Pennsylvania School of Medicine;
Associate Director of Clinical Operations Consultant Paediatric Cardiologist Staff Physician
Department of Cardiology Great Ormond Street Hospital for Children Pediatric Cardiology
Children’s Hospital Boston NHS Trust The Children’s Hospital of Philadelphia
Boston, MA, USA London, UK Philadelphia, PA, USA
vii
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List of Contributors
J. René Herlong MD Morgan Stanley Children’s Hospital of New York University College London;
Assistant Professor of Pediatrics Presbyterian Director of Echocardiography
Duke University School of Medicine; New York, NY, USA Consultant Pediatric and Fetal Cardiologist
Medical Director of Non-Invasive Imaging Great Ormond Street Hospital for Children
Duke University Medical Center Matthew S. Lemler MD London, UK
Durham, NC, USA Professor of Pediatrics
University of Texas Southwestern Medical Center Folkert Jan Meijboom MD, PhD
Lisa K. Hornberger MD at Dallas; Lecturer in Pediatric Cardiology and Adult
Professor of Pediatrics and Obstetrics and Division of Cardiology Congenital Heart Disease
Gynecology Children’s Medical Center of Dallas University of Utrecht
University of Alberta; Dallas, TX, USA Academic Medical Centre Utrecht;
Director of the Fetal and Neonatal Cardiology Staff Physician
Program Jami C. Levine MS, MD Department of Pediatrics and Cardiology
Stollery Children’s Hospital and Royal Alexandra Assistant Professor of Pediatrics Academic Medical Centre Utrecht
Hospital Harvard Medical School; Utrecht, The Netherlands
Associate in Cardiology
Edmonton, AB, Canada
Children’s Hospital, Boston Luc L. Mertens MD, PhD
Boston, MA, USA
James C. Huhta MD Section Head, Echocardiography
The Hospital for Sick Children;
Medical Director Mark B. Lewin MD
Associate Professor of Pediatrics
Non-Invasive Imaging Professor of Pediatrics
University of Toronto
All Children’s Hospital University of Washington School of Medicine;
Toronto, ON, Canada
St. Petersburg, FL, USA Chief, Pediatric Cardiology
Director of Echocardiology Laboratory
Richard A. Humes MD SSeeaattttllee ,C WhiAld, rUeSnA’s Hospital EAsrsiokci aCte. P Mrofiecsshore olff Peedldiaterircs MD
Professor of Pediatrics University of Cincinnati College of Medicine;
Wayne State University; Bart Loeys MD, PhD Director, Fetal Heart Program
Chief, Division of Cardiology Cincinnati Children’s Hospital Medical Center
Department of Pediatrics Associate Professor in Genetics Cincinnati, OH, USA
Children’s Hospital of Michigan Ghent University;
Detroit, MI, USA Assistant-Chief of Clinic
Ghent University Hospital Stéphane L.J. Moniotte MD, PhD
Ghent, Belgium Assistant Professor
Sachine Khambadkone MBBS, DcH, University of Louvain Medical School;
MD, DNB, MRCP Leo Lopez MD Staff Physician
Honorary Senior Lecturer Associate Professor of Clinical Pediatrics Pediatric Cardiology
Institute of Child Health Albert Einstein College of Medicine; Cliniques Universitaires Saint-Luc
University College London; Director of Pediatric Cardiac Non-Invasive Imaging Brussels, Belgium
Consultant Paediatric Cardiologist Children’s Hospital at Montefiore
Great Ormond Street Hospital for Children NHS New York, NY, USA James C. Nielsen MD
Trust Associate Professor of Pediatrics
London, UK Irene D. Lytrivi MD Mount Sinai School of Medicine;
Assistant Clinical Professor of Pediatrics Director, Non Invasive Imaging
Mary Etta E. King MD Mount Sinai School of Medicine; Mount Sinai Medical Center
Staff Physician New York, NY, USA
Associate Professor of Pediatrics
Pediatric Cardiology
Harvard Medical School;
Director Mount Sinai Medical Center Sharon E. O’Brien MD
Massachusetts General Hospital New York, NY, USA Assistant Professor of Pediatrics
Boston, MA, USA Boston University;
Jackie McGhie Director of Pediatric Cardiology
Congenital Cardiac Ultrasound Specialist Boston Medical Center
H. Helen Ko BS, RDMS, RDCS, FASE Erasmus University Medical Center Rotterdam Boston, MA, USA
Technical Director/Operations Manager Rotterdam, The Netherlands
Pediatric Echocardiography
Erwin Oechslin MD
Pediatric Cardiology Colin J. McMahon MB, MRCPI Associate Professor of Medicine
Mount Sinai Medical Center
Consultant Paediatric Cardiologist University of Toronto;
New York, NY, USA
Department of Paediatric Cardiology Director, Toronto Congenital Cardiac Centre for
Our Lady’s Hospital for Sick Children Adults;
Wyman W. Lai MD, MPH Dublin, Ireland Staff Physician, Cardiology
Associate Professor of Clinical Pediatrics University Health Network
Columbia University; Jan Marek MD, PHD Peter Munk Cardiac Centre
Director Associate Professor of Cardiology Toronto General Hospital
Non-Invasive Cardiology Imaging Institute of Child Health Toronto, ON, Canada
viii
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List of Contributors
Ira A. Parness MD Director, Echocardiography Laboratory Children’s Hospital and Regional Medical Center
Professor of Pediatrics Medical University of South Carolina Seattle, WA, USA
Mount Sinai School of Medicine; Charleston, SC, USA
Chief, Division of Pediatric Cardiology Theresa A. Tacy MD
Mount Sinai Medical Center John M. Simpson MD, FRCP Associate Professor of Pediatrics
New York, NY, USA Lucile Packard Children’s Hospital
Honorary Senior Lecturer in Heart Disease
Stanford University;
King’s College;
Christina Phelps MD Director, Echocardiography Laboratory
Consultant in Pediatric and Fetal Cardiology
Senior Fellow, Children’s Hospital Denver Lucile Packard Children’s Hospital
Director of Paediatric Echocardiography
The Children’s Hospital Stanford University
Evelina Children’s Hospital
University of Colorado Health Sciences Center Stanford, CA, USA
Guy’s and St Thomas’ NHS Foundation Trust
at Denver
London, UK
Aurora, CO, USA Elif Seda Selamet Tierney MD
Instructor in Pediatrics
Andrew J. Powell MD Tajinder P. Singh MD, MSc Harvard University;
Associate Professor of Pediatrics Assistant Professor of Pediatrics Assistant in Cardiology
Harvard Medical School; Harvard Medical School Department of Cardiology
Director, Cardiovascular MRI Harvard University; Children’s Hospital Boston
Children’s Hospital Boston Staff Physician Boston, MA, USA
Pediatric Cardiology
Boston, MA, USA
Children’s Hospital Boston Cecile Tissot MD
Boston, MA, USA
Claudio Ramaciotti MD Research Associate at the Children’s Hospital
Professor of Pediatrics Denver
University of Texas Southwestern Medical Center; Thierry Sluysmans MD, PhD The Children’s Hospital
Director of Echocardiography Laboratory Professor of Pediatrics University of Colorado Health Sciences
Children’s Medical Center of Dallas Université Catholique de Louvain; Center at Denver
Dallas, TX, USA Director, Cliniques Universitaires Saint Luc Aurora, CO, USA;
Brussels, Belgium Attending Cardiologist
The Children’s Hospital
Jack Rychik MD
Geneva, Switzerland
Professor of Pediatrics Jeffrey F. SmallhornMBBS, FRACP,
University of Pennsylvania School of Medicine;
FRCP(c) Manfred Otto Vogt MD, PhD
Director, Fetal Heart Program at the Cardiac Center
Professor of Pediatrics Consultant Pediatric Cardiologist
The Children’s Hospital of Philadelphia
University of Alberta; Technical University Munich
Philadelphia, PA, USA
Director, Echocardiography Laboratory German Heart Center Munich
Program Director, Pediatric Cardiology Clinic for Pediatric Cardiology and Congenital
Jack C. Salerno MD Stollery Children’s Hospital Heart Disease;
Associate Professor of Pediatrics Edmonton, AL, Canada Head of Echo-Lab
University of Washington School of Medicine; Pediatric Cardiology and Congenital Heart Defects
Staff Physician Carolyn T. Spencer MD German Heart Center Munich
Pediatric Cardiology Munich, Germany
Assistant Professor of Pediatrics
Seattle Children’s Hospital
Department of Cardiology
Seattle, WA, USA Harvard Medical School; Luciana T. Young MD
Staff Cardiologist Associate Professor of Pediatrics
Ulrike E. Salzer-Muhar MD Children’s Hospital Boston Northwestern University Feinberg School of
Associate Professor of Pediatrics Boston, MA, USA Medicine;
Medical University of Vienna; Director, Echocardiography Laboratory
Division of Pediatric Cardiology Children’s Memorial Hospital
Department of Pediatrics and Adolescent Medicine Shubhika Srivastava MBBS Chicago, IL, USA
Vienna General Hospital Associate Professor of Pediatrics
Vienna, Austria Director, Echocardiography Laboratory Adel K. Younoszai MD
Mount Sinai Medical Center
Assistant Professor
New York, NY, USA
Girish S. Shirali MBBS University of Colorado;
Professor of Pediatrics and Obstetrics/Gynecology Director, Echocardiography Laboratory
Vice-Chair for Fellowship Education J. Geoffrey Stevenson MD The Children’s Hospital
Department of Pediatrics, Medicine and Molecular Professor of Pediatrics University of Colorado Health Sciences Center at
Biology and Genetics University of Washington Denver
Medical School of South Carolina; Director, Cardiac Ultrasound Aurora, CO, USA
ix
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Preface
The genesis of this book was motivated by our recognition Therefore, the book includes a DVD with hundreds of exam-
that it has been well over a decade since the publication of ples of key anatomic and functional issues mentioned in the
a textbook of pediatric echocardiography. Indeed, the field has text. We hope that future editions will be fully electronic and
since witnessed many technological advances as well as dra- accessible on the internet. As with any medical textbook, the
matic growth in clinical applications. We were encouraged to rapid advances in our field will soon require that new infor-
pursue this work mostly by our trainees and colleagues, who mation be added to maintain its relevance. It is, therefore,
repeatedly told us that the field lacks a comprehensive, con- important to us to hear from our readers on how to improve
temporary source of information that describes the integra- the next edition.
tion of cardiac ultrasound into clinical practice in patients This book is the product of many excellent contributions
with congenital and acquired pediatric heart disease. We from the best experts in the field, both from Europe and from
debated the merits of a printed textbook in this era of elec- North America. We are indebted to their hard work, dedica-
tronic information and instant access to the latest literature tion, and exceptional talents. We also wish to express im-
over the web. After much discussion we concluded that mense gratitude to our mentors who have inspired us, to our
although the latest research papers and review articles are colleagues who have encouraged and supported us through-
indeed readily available, they do not substitute for a source out this project, to the many talented sonographers who
of information that systematically covers the field topic-by- produced most of the excellent images used in this work,
topic, and educates the reader about all aspects related to and to our trainees whose questions and quest for know-
echocardiography in patients with congenital heart disease, ledge provided the primary motivation for this book. We
from the fetus to adult. are also grateful to the staff at Wiley-Blackwell for their sup-
Our aim was to provide a comprehensive, integrated port and professionalism with the production of this book.
approach to pediatric cardiac ultrasound that incorporates all Finally, and most importantly, we wish dedicate this book to
contemporary technologies. We feel it is important to include our families, whose unwavering support has made this work
detailed information about the anatomy and pathophysio- possible.
logy of each lesion and to describe the goals and techniques of
the echocardiographic examination before, during, and after Wyman W. Lai, MD, MPH
treatment. Although still images are helpful in highlighting Luc L. Mertens, MD
certain anatomic and functional features of many conditions, Meryl S. Cohen, MD
they do not substitute for visualizing the heart in cine loops. Tal Geva, MD
xi