PMC7733707_01
TTE of ARAF. ARAF flow through the sinus of Valsalva near the RCC-NCC commissure to the tricuspid annuloplasty ring and the other side of the tricuspid annulus as shown by TTE with Doppler. ARAF, aorto-right atrial fistula; LA, left atrium; NCC, noncoronary cusp; RA, right atrium; RCC, right coronary cusp; RV, right ventricle; TTE, transthoracic echocardiogram.
10-1055-s-0040-1718552-i200369crc-1.jpg
PMC7733707_01_10-1055-s-0040-1718552-i200369crc-1.jpg
FI200369crc-1
TTE after 9 months revealed ARAF, which was not present at the postoperative TTE. The shunt jet passed through the sinus of Valsalva near the noncoronary cusp (NCC)/ right coronary cusp (RCC) commissure to the anterior annulus of the tricuspid valve near the commissure between the septal leaflet and the anterior leaflet ( Fig. 1 ).
PMC7733707_02
TTE of ARAF. ARAF flow through the sinus of Valsalva near the NCC to the right atrium as shown by TTE with Doppler. ARAF, aorto-right atrial fistula; LA, left atrium; NCC, noncoronary cusp; RA, right atrium; RCC, right coronary cusp; RV, right ventricle; TTE, transthoracic echocardiogram.
10-1055-s-0040-1718552-i200369crc-2.jpg
PMC7733707_02_10-1055-s-0040-1718552-i200369crc-2.jpg
FI200369crc-2
A postoperative TTE showed no residual MR and mild TR; however, an ARAF was detected which was not present in the intraoperative transesophageal echocardiogram ( Fig. 2 ).