Congenital septal abnormalities in the adult patient

Abstract

Echocardiography is the primary imaging method for the diagnosis and assessment of congenital heart disease in the pediatric and adult groups of patients. In the group of congenital septal defects, transthoracic echocardiography (TTE) is the primary modality to characterize the type of defect (atrial septal defect, ventricular septal defect, and atrioventricular septal defect) and to describe the echoanatomic and physiopathological features of a singular lesion that is generally involved in a shunt and the associated defects. Particularly in the adult patient with substandard echocardiographic precordial windows, transesophageal echocardiography (TEE) has permitted the acquisition of anatomic and hemodynamic information not obtainable by TTE. In this chapter, we accentuate the role of color Doppler echocardiography and contrast echocardiography for the accurate diagnosis of a septal defect; these techniques are useful also during reparation of defects, particularly by percutaneous closure: in this case use of 2-D TEE is mandatory, but today use of 3-D echocardiography and intracardiac echocardiography is growing. We underline that echocardiography is fundamental for intensivists because it permits primarily immediate diagnosis and clinical treatment of adult patients with a congenital septal defect and so it is possible to send these kinds of patients at an early stage to a center which routinely manages congenital heart diseases. Echocardiography plays an essential role in the diagnosis and management of congenital septal abnormalities because it has high sensitivity. As well as cardiologists, intensivists and anesthesiologists also are frequent users of it in their daily work.