Diagnostic indications Nondiagnostic transthoracic echocardiography in suspected CHD Evaluation of intracardiac or extracardiac baffles following the Fontan. Senning or Mustard procedure Other general indications, not characteristic only of CHD (infective endocarditis, prosthetic valve function, prior cardioversion, etc.) Perioperative indications TOE guided interventions (e.g., atrial septal defect closure)

Prior to every examination one should be fully aware of: Clinical indications for the study (questions to be answered to offer a best therapeutic option). Conclusions and uncertainties still existing after a complete transthoracic echocardiography. Course of the disease, current clinical data, in particular the presence of arrhythmia and degree of desaturation in cyanotic patients.