@Article{chd.12774,
AUTHOR = {Alan F. Riley, Elena C. Ocampo, Joseph Hagan, M. Regina Lantin‐Hermoso},
TITLE = {Hand‐held echocardiography in children with hypoplastic left heart syndrome},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {5},
PAGES = {706--712},
URL = {http://www.techscience.com/schd/v14n5/38836},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> When performed by cardiologists, hand‐held echocardiography (HHE) 
can assess ventricular systolic function and valve disease in adults, but its accuracy 
and utility in congenital heart disease is unknown. In hypoplastic left heart syndrome 
(HLHS), the echocardiographic detection of depressed right ventricular (RV) systolic 
function and higher grade tricuspid regurgitation (TR) can identify patients who are 
at increased risk of morbidity and mortality and who may benefit from additional 
imaging or medical therapies.<br/>
<b>Methods:</b> Children with HLHS after Stage I or II surgical palliation (Norwood or Glenn 
procedures) were prospectively enrolled. Subjects underwent HHE by a pediatric 
cardiologist on the same day as standard echocardiography (SE). Using 4‐point scales, 
bedside HHE assessment of RV systolic function and TR were compared with blinded 
assessment of offline SE images. Concordance correlation coefficient (CCC) was used 
to evaluate agreement.<br/>
<b>Results:</b> Thirty‐two HHEs were performed on 15 subjects (Stage I: n = 17 and Stage 
II: n = 15). Median subject age was 3.4 months (14 days‐4.2 years). Median weight 
was 5.9 kg (2.6‐15.4 kg). Bedside HHE assessment of RV systolic function and TR 
severity had substantial agreement with SE (CCC = 0.80, CCC = 0.74, respectively; 
P < .001). HHE sensitivity and specificity for any grade of depressed RV systolic 
function were 100% and 92%, respectively, and were 94% and 88% for moderate or 
greater TR, respectively. Average HHE scan time was 238 seconds.<br/>
<b>Conclusions:</b> HHE offers a rapid, bedside tool for pediatric cardiologists to detect RV 
systolic dysfunction and hemodynamically significant TR in HLHS.},
DOI = {10.1111/chd.12774}
}