Two-dimensional echocardiographic visualization of the aortic arch by right parasternal scanning in neonates and infants.

Echocardiography has previously been of limited use in visualizing the aorta in neonates and infants. Using a new technique--right parasternal scanning--the aortic arch and brachiocephalic vessels were studied in 50 children under 18 months of age. Complete visualization was accomplished in 47 patients including those 1) under 1,000 grams, 2) with indwelling endotracheal tubes, 3) who had D- or L-transposition, or 4) with right or double aortic arch. Inadequate studies were related to bilateral pneumothorax (2 neonates) and lack of cooperation (1 infant). Close correlation was obtained between images of the aorta by echocardiography and by angiography. Two-dimensional echocardiography can now visualize the aortic arch in small infants and children. In conjunction with another new technique--simultaneous Doppler flow-detection--coarctation of the aorta can be completely evaluated noninvasively in children of all ages including neonates.