PMC3263583_01
Intraoperative TEE demonstrating a patent LVOT (unlabeled arrow) and the large membranous VSD. Key: LVOT:left ventricular outflow tract, TEE:transesophageal echocardiogram, VSD:ventricular septal defect.
PEDIATRICS2011-534940.001.jpg
PMC3263583_01_PEDIATRICS2011-534940.001.jpg
fig1
Preoperative transesophageal echocardiography (TEE) demonstrated a large membranous VSD that extended into the inlet septum and a widely patent left ventricular outflow tract (Figure 1). 
PMC3263583_02
Intraoperative TEE post-VSD repair demonstrating the DVSH (unlabeled arrow) and the systolic narrowing of the LVOT caused by the anterior mitral leaflet/chordal apparatus coming in contact with the DVSH (AML/Chordae). Key: AML/Chordae:anterior mitral leaflet/chordal apparatus, DVSH:dissecting ventricular septal hematoma, LVOT:left ventricular outflow tract, TEE:transesophageal echocardiogram, VSD:ventricular septal defect.
PEDIATRICS2011-534940.002.jpg
PMC3263583_02_PEDIATRICS2011-534940.002.jpg
fig2
Post-evacuation TEE demonstrating no residual DVSH and a widely patent LVOT. Key: DVSH:dissecting ventricular septal hematoma, LVOT:left ventricular outflow tract, TEE:transesophageal echocardiogram.
PEDIATRICS2011-534940.003.jpg
PMC3263583_02_PEDIATRICS2011-534940.003.jpg
fig3
TEE confirmed a widely patent LVOT with no residual gradient (Figure 3). The LVOT remained widely patent on transthoracic echocardiography performed five days later.