• Transitional AV Canal
    • Large primum ASD
    • Inlet VSD largely occluded by accessory AV valve tissue
    • Moderate right atrial dilation
    • Mildly dilated and hypertrophied right ventricle
  • Transitional AV canal defect
    • Moderate right AV valve regurgitation
    • Mild to moderate left AV valve regurgitation
    • Trivial amount of shunting through inlet VSD which appears largely occluded by accessory AV valve tissue (turbulent red color Doppler jet)
  • Transitional AV Canal
    • Moderate primum ASD with lett to right shunting
    • Small inlet VSD largely occluded by accessory AV valve tissue with left to right shunting
    • Moderate right AV valve regurgitation
    • Mild to moderate left AV valve regurgitation
    • Moderate right atrial dilation

Echocardiographic Assessment: Apical 4 Chamber

  • Primum ASD (size and direction of shunting)
  • Inlet VSD (size, assess for accessory AV valve tissue which often mostly or completely occludes VSD oriface)
  • Right ventricle (dilation, hypertrophy, function)
  • Left ventricle (dilation, hypertrophy, function)
  • Atrioventricular valves (typicaly two orifaces)
  • Right AV valve (stenosis or regurgitation)
  • Left AV valve (stenosis or regurgitation)

 

 

  • Transducer placed on apical PMI (4th or 5th intercostal space)
  • Midclavicular line at the apical PMI (point of maximal intensity)
  • Notch at 3 o'clock