Deformation imaging in selected congenital heart disease: is it evolving to clinical use?

Deformation imaging allows the direct interrogation of myocardial performance, expanding the ability to evaluate ventricular function in children with congenital heart disease (CHD), including assessment of the subpulmonary and systemic right ventricle, single ventricles, and morphologically abnormal left ventricles. Deformation imaging has provided new insights into the pathophysiology of CHD and diagnostic and prognostic information not readily available using conventional echocardiography. However, at present, deformation imaging is not widely used in clinical pediatric echocardiography. In this review, the authors address the various techniques, their evolving use in CHD, where they have provided important insights in CHD, pitfalls and current limitations to their use, and suggestions for their integration into the routine clinical armamentarium.