Echocardiography in assessment of infants with complete d-transposition of great arteries.

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Abstract
Echocardiography was performed prospectively in 43 infants with complete d-transposition of the great arteries (d-transposition), 29 of whom were in the 1st wk of life. When the final diagnosis was established an assessment was made of the reliability of the echocardiographic findings and their contribution to the clinical diagnosis. The atrioventricular valves were correctly assessed in 40 infants and incorrectly in 3, the error being important in 1. The ventricular septum was recorded in 42 and failure to record a normal septum occurred in 1. Abnormal great arterial root positions were recorded by echocardiography in 35 of 43 infants, but minor variations in position could not be detected with accuracy. Assessment of the root positions was incomplete in 7 of 43 and incorrect in 1. The great arterial root positions were determined by cineangiocardiography and showed pronounced variation, as occurs in connection disorders other than d-transposition. The connection diagnosis cannot be established by the demonstration of any particular root positions. Echocardiography made a significant contribution to the clinical diagnosis of d-transposition in 35 of 43 infants (81%); findings were incomplete in 5 of 43 (12%). Seriously misleading information was provided in 3 of 43 (7%). Echocardiography aids management in the majority of infants with d-transposition and can help to exclude this condition in infants who are hypoxic from other causes.