SSN aortic arch | Pediatric Echocardiography

Aortopulmonary window
- Holodiastolic flow reversal in the descending aorta secondary to a large left to right shunt with diastolic flow abnormality as can be seen with a large AP window (red color Doppler jet in descending aorta)

Aortopulmonary window
- Spectral Doppler in the descending aorta revealing holodiastolic flow reversal in the setting of a large left to right shunt with diastolic flow abnormality as is commonly seen with a large AP window
- D = holodiastolic flow reversal

Echocardiographic Assessment: Suprasternal Notch Aortic Arch
- Color Doppler: Confirms shunting across the AP window between the great arteries. Furthermore, thorough evaluation of the arch is important to rule-out possible association of interrupted arch (commonly type A interrupted aortic arch) or presence of associated coarctation.
- Spectral Doppler: Pulse wave doppler at the descending thoracic aorta distal to the take-off of the left subclavian artery confirms holo-diastolic flow reversal in the descending thoracic aorta secondary to large left-to-right shunt across the AP window. This can be confirmed by Spectral Doppler of the abdominal aorta from subcostal abdominal long axis view.