The validity of structure identification for cross‐sectional echocardiography

Intra‐ and extracardiac structure identification by cross‐sectional echocardiography was achieved during hemodynamic study in ten patients by visualizing catheter echoes, or echoes produced after selective chamber injections of indocyanine green dye. Four cross sections were employed: (1) a long‐axis sagittal view of the right and left ventricles, (2) a transverse cross section of the right and left ventricles in the fourth intercostal space; (3) a sagittal view along the right ventricular outflow tract, and (4) a transverse section of great vessel orientation in the second intercostal space. Passage of dye through the left atrium, left ventricle, and aorta was visualized in sagittal and transverse cross sections. Further identification of left‐sided structures was obtained by the detection of catheter‐induced echoes. Passage of the dye through the right ventricular outflow tract and main pulmonary artery, as well as visualization of catheter artifacts, identified right heart landmarks in a precise fashion. In addition, right‐ and left‐sided structures were opacified in patients with left‐to‐right and right‐to‐left shunts after dye injections into a contralateral cardiac chamber. This study confirms the accuracy of real‐time cross‐sectional echo localization of cardiac chambers and valves in the positions used routinely for the assessment of congenital and acquired cardiac disease in pediatric patients.