EKG - PR interval

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Tissue Doppler Imaging - Mitral Lateral Annulus TDI

From Tighe DA, et al. Cardiac Ultrasound Today 2005;11(5):89-116.

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Normal TDI of Lateral Mitral Annulus

(S', E', A' velocities are measured in cm/sec)

Age-related change in Lateral Mitral Annulus TDI

(24 yr old on the left; 82 yr old on the right)

Lateral Mitral Annulus TDI

(Impaired Relaxation: E' velocity is lower than A' velocity)

Lateral Mitral Annulus TDI

(Restrictive Pattern: Both E' & A' velocities are reduced, E' velocity is higher than A' velocity though)

Diastolic Function by Doppler - Mitral Inflow, Pulmonary vein flow (Normals)

Mitral Inflow Doppler (Normal)

DT - DecelerationTime of E wave

Adur - A wave Duration

Pulmonary vein flow Doppler pattern

(S, D and Atrial reversal)

(From Tighe DA, et al. Cardiac Ultrasound Today 2005;11(5):89-116)

Diastolic Function: Echo parameters

Assessment of Diastolic Function using Echo Parameters

Tables from Wyman Lai's Pediatric Echocardiography Textbook (2009)

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Table 8.2: Inflow Doppler Values (Infants & Children)

Adapted from Eidem BW, et al. JASE 2004;17:212-21.

Table 8.3: Annular Doppler Tissue Imaging Values (Infants & Children)

Table 35.3: Echo parameters of diastolic function (Adult)

(Tam JW. et al. Curr Opin Cardiol 2002;17:470-7)

Table 35.4: Echo parameters for diastolic function (Child & Adult)

(Garcia MJ, et al. JACC 1998;32(4):866-75)

(Courtesy: Ashish)

PA-VSD Decision Tree

From Lofland GK. Progress in Pediatric Cardiology 2009;26:65-70

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Accessory Hemiazygos Vein

Accessory Hemiazygos Vein

Subclavian Steal - Mechansim

Arteries that form the basis for Subclavian Steal Syndrome

Oxygen Consumption (Lundell et al. Table)

Adapted from Lundell et al. Pediatr Cardiol 1996;17:207-13.

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Diabolo Stent

Diabolo stent placement technique (Fontan Fenestration)

O.Stumper et al. Heart 2003;89:1227-30.

Technique: 3-4 mm diameter loop is created using temporary epicardial pacing wires as follows: The needle ends are removed. 5 cm of the wire tips are bared of its insulation. The 2 bare wire ends are tied in a loop. This provides ~90 cm long wire. A secure double-knot over a 10-14 French dilator.

The loop is paced over a 15-25 mm Valvuloplasty balloon (?low pressure). J&J P308 or P188/JoMed 17 mm stents are options. The stent is gently dilated using 10-14 French dilator and then, mounted on the balloon - keeping the knotted-loop over the center of balloon.

Deliver using 11-14 Fr Mullin sheath.

 

Recommendations and Level of Evidence Classification

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