• Supracardiac Total Anomalous Pulmonary Venous Return
    • Dilated right ventricle
    • Small underfilled LV
    • Interventricular septal flattening 
      • Pressure and volume loaded RV 

Echocardiographic Assessment: Subcostal Ventricles

  • Assess right ventricular size and function
  • Assess left ventricular size and function
  • Assess interventricular septal configuration
    • Systolic interventricular septal flattening:  Pressure loaded right ventricle in setting pulmonary hypertension
    • Diastolic interventricular septal flattening: Volume loaded right ventricle in setting of increased right sided volume from anomalous pulmonary venous retur

  • Transducer on abdomen just below xiphoid process
  • Notch at 6 o'clock
  • Probe tilted towards patient's left shoulder