- Tetralogy of Fallot
- MIldly hypoplastic pulmonary valve
- Confluent branch pulmonary arteries
- Tetralogy of Fallot
- Moderately hypoplastic dysplastic pulmonary valve
- Anterior deviation of the subpulmonary infundibulum into the right ventricular outflow tract (denoted by the star)
- Large perimembranous outlet VSD
- Tetralogy of Fallot
- Moderately hypoplastic pulmonary valve
- Anterior deviation with hypertrophied subpulmonary infundibulum into the right ventricular outflow tract causing dynamic obstruction (denoted by the star)
- Large perimembranous outlet VSD
- Tetralogy of Fallot
- Severe dynamic subpulmonary obstruction
- Anterior deviation of the subpulmonary infundibulum
- Infundibular hypertrophy with near obliteration of the right ventricular outflow tract secondary to hypertrophied infundibulum (starred structure)
- Tetralogy of Fallot
- Moderately hypoplastic pulmonary valve with flow turbulence consistent with pulmonary stenosis
- Anterior deviation with hypertrophied subpulmonary infundibulum into the right ventricular outflow tract (denoted by the star)
- Large perimembranous outlet VSD with bidirectional shunting
- Mild tricupid regurgitation
- Tetralogy of Fallot
- Mildly hypoplastic pulmonary valve
- Anterior deviation with hypertrophied subpulmonary infundibulum into the right ventricular outflow tract (denoted by the star) causing dynamic subpulmonary stenosis with flow turbulence
- Large perimembranous outlet VSD
- Tetralogy of Fallot
- Mildly hypoplastic pulmonary valve and main pulmonary artery with flow turbulence across the pulmonary valve
- Anterior deviation of the subpulmonary infundibulum into the right ventricular outflow tract (denoted by the star) with mild flow turbulence in the right ventricular outflow tract by color Doppler
- Large perimembranous outlet VSD
- Tetralogy of Fallot
- Anterior deviation with hypertrophied subpulmonary infundibulum (denoted by the star) into the right ventricular outflow tract causing dynamic subpulmonary stenosis with flow turbulence
- Large perimembranous outlet VSD with left to right shunting
- Tetralogy of Fallot
- Moderate to severe pulmonary valve stenosis in infant with tetralogy of Fallot with a peak velocity of ~4.2 meters/sec with a peak gradient of ~70 mmHg.
- Tetralogy of Fallot
- "Dagger-like" Doppler pattern revealing dynamic obstruction in the right ventricular outflow tract in infant with tetralogy of Fallot
Echocardiographic Assessment: Parasternal short axis
- Assess infundibular obstruction (2D, color and spectral Doppler, spectral Doppler both pulse and continuous wave)
- Continuous wave Doppler interrogation of the right ventricular outflow tract demonstrates high-veloctiy flow with late-peaking, dagger-shaped flow consistent with dynamic infundibular obstruction.
- Assess anterior deviation of infundibular septum into RVOT with dynamic obstruction
- Assess pulmonary valve size and anatomy (2D, color, spectral Doppler both pulse and continuous wave)
- Assess main pulmonary artery size branch pulmonary artery size and degree of the obstruction (2D, color and spectral Doppler both pulse and continuous wave)
- Evaluate VSD anatomy (size by 2D, color, spectral both pulse and continuous wave)