PMC3987384_01
The chest X-ray shows an enlarged heart, long ventricular and long middle left
arch, and increased pulmonary vascular bed. The middle arch suggests the aorta
emerging from the right ventricle to the left. Four-chamber apical
echocardiography highlights in A the double inlet tract of single left ventricle
with two atrioventricular valves, and in B, in the same projection, moderate
insufficiency of the right atrioventricular valve (mosaic of regurgitation).
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The pulmonary vascular bed was increased (Figure 1). Echocardiogram (Figure 1) showed double inlet tract of single left ventricle with ventriculoarterial discordance, aorta emerging from the right rudimentary ventricle to the left and pulmonary valve atresia.
Heart angiocardiography highlights the right superior vena cava in connection with
the right pulmonary artery of good diameter, and the beginning of the venovenous
vessel in A, which continues bordering the heart, B, and goes into the right
atrium, in C. The left pulmonary artery is of good caliber and with discrete
pre-hilar narrowing in D.
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Catheterization and cardiac tomography (Figure 2) revealed a venous vessel diverting the flow of the right superior vena cava by the innominate vein to the coronary sinus.