Modern echocardiography in pediatric right heart assessment

Right heart function is a key determinant of clinical status, prognosis and outcome in a variety of heart diseases, particularly in patients with congenital heart disease. Various non-invasive imaging tools have been used to assess right heart function in the setting of adult heart disease; however there has been little exploration of those modalities in younger patients. Newer imaging techniques, including tissue Doppler imaging, three-dimensional echocardiography and deformation imaging have been added to the armamentarium of the congenital non-invasive imager. My aims were to investigate the feasibility and usefulness of newer echocardiographic tools of right heart assessment in the setting of pediatric and adult congenital heart disease. The 9 projects outlined in this thesis investigates the right heart in pediatric and congenital heart disease, encompassing systemic veins, right atrium, right ventricle, and focusing on size, volumes, flow and function. The goal of these investigations was to evaluate right heart performance non-invasively in daily clinical practice and to understand which indices could be used in clinical decision-making.