Echocardiographic Assessment: Parasternal long axis

• VSD anatomy (size, direction of shunting by color and spectral Doppler, often bidirectional shunting secondary to large VSD, increased RV pressures)
• Overriding aorta (position of aorta, degree of override)  
• Demonstrate aortic-to-mitral continuity
  • Aortic-to-mitral continuity consistent with TOF
  • Aortic-to-mitral discontinuity consistent more with double outlet right ventricle (DORV)
  • Assess RV size (assess for RVH commonly found with TOF)
  • Assess biventricular systolic function