PMC10077769_01
Image of the stent deployed in the ductus arteriosus by interventional cardiac catheterization
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F1
Deployment of a 4 mm drug-eluting stent in the ductus arteriosus with simultaneous atrial balloon septostomy was done as an emergency procedure [Figure 1]. An agitated saline injection into the left internal jugular vein showed the rapid appearance of the saline contrast in the atrium by transesophageal echocardiography [Figure 2c and d, Videoclip 1].
(a-d) A modified left suprasternal 2-D transthoracic echocardiography view (a) with color Doppler (b) showing a laminar flow through the left vena cava. A mid-esophageal 4-chamber transesophageal echocardiography view showing the chambers of the heart before (c) and after (d) agitated saline injection into the left internal jugular vein
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F2
A modified left suprasternal two-dimensional (2-D) transthoracic echocardiography view with color Doppler demonstrated a laminar blood flow across the left Glenn shunt [Figure 2a and b]. An agitated saline injection into the left internal jugular vein showed the rapid appearance of the saline contrast in the atrium by transesophageal echocardiography [Figure 2c and d, Videoclip 1].
Venous angiography showing the underlying pathology for the profound hypoxemia and the cause for the rapid appearance of the agitated saline in the atrium
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F3
Angiographic contrast injection identified an azygos vein communicating with inferior vena cava causing the rapid appearance of the saline contrast in the chambers of the heart mimicking pulmonary arteriovenous malformations in the presence of an obstructed right Glenn shunt [Figure 3].