Common atrioventricular (AV) canal consist of a group of structural heart m
alformations that share some common features but can vary widely with respe
ct to anatomic features and physiologic manifestations. High quality, non-i
nvasive evaluation can define the anatomic features of the disease and give
cardiologists a full appreciation of the hemodynamic issues. Patients with
common AV canal frequently require surgical intervention and the importanc
e of non-invasive evaluation in the intra-operative, peri-operative and pos
t-operative periods has grown along with the technology. Echocardiographic
technology has progressed rapidly over the last 25 years, revolutionizing t
he evaluation of structural heart disease. Patients with suspected common A
V canal can now be completely evaluated non-invasively in most cases. Using
two-dimensional imaging, color and spectral Doppler, the cardiologist can
fully assess cardiac anatomy, hemodynamics and ventricular function. The sm
aller, high resolution transducers introduced in recent years allow for exc
ellent imaging in newborns. The availability of small transesophageal trans
ducers has made intraoperative study available to patients as small as 2.5
kg. The contribution of three-dimensional echocardiography is still in the
investigational stages, but it is likely that it will be important for the
further delineation of valve anatomy and for the quantitative assessment of
valve and ventricular function. This article reviews the current use of ec
hocardiography in the evaluation of common AV canal, including the initial
diagnostic evaluation as well as the intra-operative, post-operative and pr
enatal evaluation. (C) 1999 Elsevier Science Ireland Ltd. All rights reserv
ed.