Basic Principles of Echocardiography in Adults with Congenital Heart DiseaseAnita Sadeghpour6.1. Basic Principles of Echocardiography in Adults with Congenital Heart DiseasePatients with adult congenital heart disease (ACHD) present with a range of cardiac pathologies, ranging from simple "holes in the heart" to the complex anatomy of the single ventricle. Some patients have undergone palliative therapy or complete surgical repair, while others maintain their native cardiac condition. In all these situations, echocardiography remains the mainstay of diagnosis for patients with coronary artery disease. The following basic principles should be kept in mind when imaging patients with suspected coronary artery disease:1. In all likelihood, the presence of one congenital anomaly denotes the existence of more. Whether trying to diagnose the most basic of communications between the atria or trying to pinpoint the most complex of malformations, the goal of the sequential segmental modality is to demonstrate normality. This is why we subject a patient with an isolated atrial septal defect, in the context of a normally constructed heart, to the same scrupulous analysis as a patient with congenitally corrected transposition of the great arteries associated with multiple intracardiac defects.2. The patient's medical history and/or written surgical report must be meticulously reviewed even before meeting the patient. The echocardiographer's in-depth knowledge of the details of the patient's previous repairs allows for a clearer and more efficient imaging investigation.3. Inspection of the patient's color, fingers, and chest would be helpful. Is the patient cyanotic with clubbed fingers? After all, a cyanotic patient is more likely to have complex malformations. The presence of the central part of the paper. The advantages of three-dimensional (transthoracic and transesophageal) echocardiography over two-dimensional echocardiography have been suggested in the following situations:1. Evaluation of left ventricular volumes and ejection fraction; Three-dimensional echocardiography has been clearly demonstrated to provide more accurate and reproducible measurements.2. Evaluation of mitral valve pathology should be integrated into routine clinical practice as three-dimensional echocardiography provides the best physiological and morphological information regarding the mitral valve (Figure 6.16).3. Guide to interventional procedures on the mitral valve (three-dimensional transesophageal echocardiography). It is noteworthy, however, that three-dimensional evaluation of the tricuspid valve, pulmonary valve, and prosthetic valves has yet to be fully studied.