- Transposition of the Great Arteries
- Small restrictive atrial septal defect with turbulent left to right flow noted
- Transposition of the Great Arteries
- Spectral Doppler across a restrictive atrial septum demonstrating a high mean gradient consistent with a restrictive atrial communication
- Transposition of the Great Arteries
- Ballon atrial septostomy performed to enlarge atrial communication
- Ballon can be visualized in the left atrium being pulled across the atrial septum into the right atrium
- Transposition of the Great Arteries (post ballon atrial septostomy)
- Atrial septal defect is seen following ballon atrial septostomy
- Enlargement of atrial communication with floppy redundant septum primum tissue
- Transposition of the great arteries (D-TGA)
- Balloon atrial septostomy in patient with small restrictive ASD
- Following septostomy a moderate sized atrial communicaiton is seen
- Transposition of the great arteries (D-TGA)
- Following balloon atrial septostomy
- Moderate sized unrestrictive atrial communication is observed with predominantly left to right shunting
- Transposition of the great arteries (D-TGA)
- Large secundum ASD with unrestrictive bidirectional shunting
- Transposition of the great arteries (D-TGA)
- Sequence of clips (subcostal view)
- First clip demonstrates a restrictive atrial septum (PFO) with left to right shunting
- Subsequent clip is of a balloon atrial septosomy
- Final clip reveals an enlarged atrial communication following septostomy with left to right shunting
- Sequence of clips (subcostal view)
- Transposition of the Great Arteries
- Unrestrictive ASD with bidirectional shunting following balloon atrial septostomy
The subcostal view profiling the atrial septum is a very important view in patients with transposition of the great vessels. This view can be used to assess the size and location of an atrial septal defect which is critical to have in these patients as they rely on this communication for proper mixing of the parallel circulations. If the degree of mixing at the atrial septum is inadequate, often a procedure called a balloon atrial septostomy is required to enlarge/create an atrial communication to improve intracardiac mixing.
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- Transducer located in the abdomen just below xyphoid process
- Notch at 3 o'clock
- Transducer tilted anteriorly (tail down)
- ASD
- Assess size and degree of mixing in patients with transposition
- A small ASD with inadequate mixing may require a balloon atrial septostomy