Figure 6

Figure 6 : 

3D echocardiography of DORV. DORV is a lesion for which an understanding of the precise morphology is essential to plan surgical intervention. This can be achieved by interrogation of the volumetric dataset using multiplanar reformatted images and rendered 3D images. A. Multiplanar reformatted images from a patient with DORV. This technique permits interrogation of the echocardiographic dataset in any user defined planes. It is particularly helpful to “step through” the anatomy in complex morphologies. B. Rendered 3D echocardiogram projected form the ventricular aspect. This projection demonstrates the anatomy of a patient with DORV visualized from the ventricular apex. The relationship of the left ventricle, ventricular septum (arrow heads, <) and the great arteries is depicted in a single projection. To assist orientation, the image is rotated to bring the diaphragmatic surface of the heart (marked by *) into its true anatomical position. C. Projection of DORV visualized from the right ventricle. In this projection, the free wall of the right atrium, and the right ventricle, have been cropped away. The anatomy is viewed from the right ventricular aspect to demonstrate the relationship of the tricuspid valve, the ventricular septal defect and the great arteries. This may assist in selection of the optimal mode of repair. For reference, the inferior, diaphragmatic surface of the heart is marked by asterisks (*). D. Cropped view from the ventricular apex of the heart in DORV. This projection has been cropped close to the base of the heart to demonstrate the relationship between the mitral valve, tricuspid valve, VSD, aorta and pulmonary artery. In this example, the arrow shows that a route from the left ventricle to the aorta exists without impinging on the tricuspid valve or pulmonary valve. This patient had full repair by baffling from the left ventricle to the aorta through the VSD. Ao: aorta; AoV: aortic valve; DORV: double outlet right ventricle; Inf: inferior; L: left; LV: left ventricle; MV: mitral valve; PA: pulmonary artery; R: right; RV: right ventricle; Sup: superior; TV: tricuspid valve; VSD: ventricular septal defect; <: ventricular septum.