Real-Time 3-Dimensional Echocardiography for Follow-up of Waterston Shunt

A 37- year- old man presented with Eisenmenger's reaction. He had progressive cyanosis and signs of right- sided heart failure. In early childhood he was palliated with a Waterston shunt for cyanotic congenital heart disease. Two- dimensional echocardiography provided only a rudimentary view of his heart's anatomy and hemodynamics. Real- time three- dimensional echocardiography ( RT3DE) was superior in visualizing both the size and the shape of the large shunt. RT3DE easily identifies and quantifies a key pathogenic factor for pulmonary hypertension with irreversible vascular damage in such patients. If applied early, RT3DE may prove to be a valuable follow- up tool.