Two-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 patients with corrected transposition of the great arteries (L-TGA). However, the utility of Doppler color flow imaging combined with two-dimensional echocardiography in L-TGA has not been established. Thus, we evaluated 14 adults (mean age 33 +/- 8 {SD} years) with L-TGA. Two-dimensional echocardiography demonstrated Ebstein's anomaly in five patients. Color flow imaging detected left AV valve regurgitation in 13 (moderate to severe in six); the other patient had a prosthetic valve. Right AV valve regurgitation was detected in two (mild in both). Aortic regurgitation was present in five (moderate in three). Pulmonic regurgitation was present in nine (moderate to severe in three). Pulmonic stenosis was detected in three (subvalvular in two, valvular in one) and two patients had pulmonary atresia. One patient had a bicuspid aortic valve with mild stenosis. Mean right ventricular ejection fraction (apical, area-length) was 44%; only 1 of 9 patients had a value greater than 55%. Thus, two-dimensional Doppler echocardiography with color flow imaging detects a high incidence of systemic AV valvular regurgitation and reduced right (systemic) ventricular systolic function in adults with L-TGA.