Abstract
It has not been possible to distinguish tetralogy of Fallot (TF) from truncus arteriosus (TA) by echocardiography (E) when the pulmonary valve is not identified. E from 18 patients with catheterization proven diagnosis of TA were compared to 16 patients with TF with and without pulmonary atresia. Features in common to the 2 groups included a single enlarged great vessel (83% TA, 75% TF) with overriding of the interventricular septum (78% TA, 88% TF). Differential signs included left atrial size and semilunar valve abnormalities. Left atrial enlargement was common in TA (78%) and unusual in TF (25%), reflecting differences in pulmonary blood flow. Multiple systolic and dlastolic linear duplications of the semilunar valve were recorded in 67% of TA, but were not seen in a single TF patient. These reflect either abnormal numbers of cusps, cusp asymmetries or thickenings which are extremely common in TA and rare in TF specimens. The differential diagnosis of TA can be made by E when the following criteria are met: a single enlarged great vessel, overriding the interventricular septum, left atrial enlargement, and most importantly, semilunar valve duplications.
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Shematek, J., Roland, JM., Langford Kidd, B. et al. TRUNCAL VALVE ECHOES IN THE DIFFERENTIATION OF TRUNCUS ARTERIOSUS FROM TETRALOGY OF FALLOT. Pediatr Res 11, 400 (1977). https://doi.org/10.1203/00006450-197704000-00185
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DOI: https://doi.org/10.1203/00006450-197704000-00185
