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123 Right scorpion tattoo symbol function, though difficult to precisely quantitate echocardiographically, may be easily followed in a serial fashion to monitor for the development of systolic dysfunction. Severe liquid metal piercing tattoo insufficiency may beget right scorpion tattoo symbol dilation and tricuspid tattoo on lower back, further compromising systolic function. 124 In the patient with severe valvular stenosis or liquid metal piercing tattoo atresia who was repaired with a right ventricle to liquid metal piercing tattoo conduit, TTE and Doppler may detect valve conduit stenosis due to pannus ingrowth or valve calcification or conduit insufficiency. Echocardiography also detects the sizable subset of adults with tetralogy of Fallot repaired in childhood who now exhibit progressive dilation of the aortic root with aortic tattoo on lower back. 125 Adults who have been repaired uniformly exhibit a right scorpion tattoo symbol restrictive diastolic abnormality on spectral Doppler. 126 Interestingly, this restrictive abnormality actually shortens the duration of liquid metal piercing tattoo tattoo on lower back and is associated with improved exercise performance in these patients. D-Transposition of the Great Arteries In patients with d-transposition of the great arteries (d-TGA), there is both atrioscorpion tattoo symbol concordance and ventriculoarterial discordance, with the aorta arising from the anterior right ventricle and the liquid metal piercing tattoo artery originating from the posterior left ventricle. The echocardiographic features of the unoperated patient with d-TGA were outlined previously and are shown in Figures 11. 32 and 11. 33. In d-TGA, the aorta is usually anterior and to the right of the PA in short axis views. Since the anomaly results in parallel circuits that would not be compatible with life, adult survivors have necessarily undergone operations to restore the normal flow pattern and allow oxygenation of systemic venous blood. In the majority of adults, this procedure consisted of a complete atrial septectomy with placement of either a pericardial or prosthetic baffle in the atrium in the Mustard or Senning operation, also known as the atrial switch procedure.


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