2-DIMENSIONAL DOPPLER COLOR-FLOW IMAGING IN ADULTS WITH L-TRANSPOSITION OF THE GREAT-ARTERIES

Abnormalities of the left atrioventricular (AV) (tricuspid) valve and pulmonic stenosis are part of the spectrum of manifestations in patien ts with corrected transposition of the great arteries (L -TGA). Howeve r, the utility of Doppler color flow imaging combined with two-dimensi onal echocardiography in L-TGA has not been established. Thus, we eval uated 14 adults (mean age 33 +/- 8 [SD] years) with L-TGA. Two-dimensi onal echocardiography demonstrated Ebstein's anomaly in five patients. Color flow imaging detected left AV valve regurgitation in 13 (modera te to severe in six); the other patient had a prosthetic valve. Right AV valve regurgitation was detected in two (mild in both). Aortic regu rgitation was present in five (moderate in three). Pulmonic regurgitat ion was present in nine (moderate to severe in three). Pulmonic stenos is was detected in three (subvalvular in two, valvular in one) and two patients had pulmonary atresia. One patient had a bicuspid aortic val ve with mild stenosis. Mean right ventricular ejection fraction (apica l, area-length) was 44%; only 1 of 9 patients had a value > 55%. Thus, two-dimensional Doppler echocardiography with color flow imaging dete cts a high incidence of systemic AV valvular regurgitation and reduced right (systemic) ventricular systolic function in adults with L-TGA.