- Total anomalous pulmonary venous return to the coronary sinus
- Two pulmonary veins seen draining to a confluence
- Confluence connects to coronary sinus which then drains to the right atrium
- Total anomlous pulmonary venous return to the coronary sinus
- Right and left sided pulmonary veins are seen draining to a confluence which subsequently drains to a dilated coronary sinus which then drains to the right atrium
- Total anomalous pulmonary venous return to the coronary sinus
- Two pulmonary veins seen draining to a confluence
- Confluence connects to coronary sinus which then drains to the right atrium
- Total anomalous pulmonary venous return to the coronary sinus
- Two pulmonary veins seen draining to a confluence
- Confluence connects to coronary sinus which then drains to the right atrium
Echocardiographic Assessment: Subcostal
- Assess the number of pulmonary veins
- Evaluate the pulmonary venous connections and drainage pattern
- Assess coronary sinus
- markedly dilated coronary sinus
- "whale tale" sign
- Pulmonary venous hemodynamics
- flow in veins by color Doppler
- assess for pulmonary vein stenosis in individual veins, confluence, entrance to coronary sinus)
- Evaluate the atrial septal defect (2D, color and spectral Doppler)
- Systemic venous connections
- Assess for right atrial and right ventricular dilation
- Assess for evidence of pulmonary hypertension
- tricuspid regurgitation (peak velocity to estimate RV systolic pressure)
- right ventricular dysfunction
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- Transducer located in the abdomen just below xyphoid process
- Notch at 3 o'clock
- Transducer tilted posteriorly (tail up)