Great Artery and Vascular Anomalies

Abstract

Echocardiography is the diagnostic modality of choice in the initial evaluation and serial assessment of most types of pediatric heart disease, both congenital and acquired. The anomalies of a congenital nature that most often affect the great arteries and related vascular structures are frequently first suspected and identified by high-resolution imaging provided by transthoracic echocardiography. Technological advances that have taken place during the last several decades allow for complementary noninvasive imaging modalities to be applied when further characterization of these congenital cardiovascular malformations or variants is necessary. Transesophageal echocardiography (TEE) plays a limited role in the diagnostic assessment of these anomalies and their surgical or catheter-based management, but nonetheless, it provides major contributions in the care of affected patients. In the intraoperative setting, TEE may be able to confirm the presence of selected abnormal vascular structure(s) or connection(s). More importantly, TEE facilitates the detailed evaluation of associated defects, provides for intraoperative monitoring, and allows for assessment of the surgical intervention(s). This chapter discusses the most frequently encountered great artery and vascular anomalies of a congenital nature, focusing on the applications of TEE in the evaluation of these lesions.