10 Echocardiographic Imaging of Single-Ventricle Lesions
Key Points
SV lesions are complex heart defects that result in one of the ventricles being hypoplastic or absent. The most common of these lesions are those that comprise HLHS. SV lesions are divided into three categories based on the adequacy of pulmonary blood flow (PBF) and systemic blood flow (SBF).
This chapter discusses in detail the imaging of these three lesions:
Hypoplastic Left Heart Syndrome
Definition and Prevalence
The goals of the initial echocardiogram in HLHS are to provide a complete anatomic survey and assess the underlying physiology, which play a critical role in determining the initial management of the patient. In addition to identifying the degree of hypoplasia of the left ventricular (LV) chamber and that of the MV and AV, it is important to assess the function of the RV and tricuspid valve (TV), the size and the direction of flow across the AS, ductal physiology, and associated findings such as ventriculocoronary communications or fistulae and anomalous pulmonary venous return.
Pertinent information is obtained from each of the standard views by two-dimensional (2D) and Doppler.
Parasternal Long Axis View (Fig. 10-1)
Parasternal Short Axis View

Figure 10-2 HLHS. Parasternal short axis view. Note the size discrepancy between the small LV posteriorly and the right ventricle (RV) anteriorly.
Apical Four-Chamber View
Subcostal Four-Chamber or Coronal View

Figure 10-4 HLHS. Subxyphoid long axis color compare image profiling a restricted interatrial communication with aliasing of the jet by color Doppler.
Subcostal Short Axis or Sagittal View
Suprasternal Long Axis View
Suprasternal Short Axis View
Double-Inlet Left Ventricle
Key Points

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