Two-dimensional/Doppler echocardiography and its relationship to cardiac catheterization for diagnosis and management of congenital heart disease.

The impact of echocardiography on cardiac catheterization in an individual patient with congenital heart disease depends on a number of factors, including the availability of an echocardiographer who is experienced in congenital heart disease and of appropriate "state of the art" equipment, and willingness of clinicians and surgeons to accept echocardiographic data. The latter is influenced by factors such as completeness of the echocardiographic data, familiarity with tomographic cardiac anatomy, and the perceived risk of an invasive procedure. The combined use of echocardiography and catheterization will have an increasing impact on the management of these patients, significantly altering the indications and extent of a catheterization procedure. This will lead to a more goal-directed examination. The relationship between catheterization and 2-D/Doppler echocardiography should not be adversarial, but complementary. Increasingly, noninvasive techniques will support or complement the invasive procedure, particularly as echo technologies for invasive applications are further developed.