The Role of Cross-Sectional Echocardiography in Children with Pulmonary Outflow Tract Obstruction

Palliative surgery, in the form of a systemic-to-pulmonary artery shunt, is still the main form of treatment in neonates and young infants with pulmonary outflow tract obstruction. Cross-sectional echocardiography (CSE) can accurately define the intracardiac anatomy [1–3]; thus far, however, it has provided some limitations in assessing the supracardiac structures. Before performing a shunt, in addition to ascertaining the intracardiac anatomy, it is important to assess:1) the laterality of the aortic arch [4], 2) the branching pattern of the brachiocephalic arteries (BCAs), 3) the confluence of the pulmonary arteries (PAs), and 4) the size of the subclavian and pulmonary arteries. This study evaluates the role of CSE in determining these factors.