PMC10243663_01
(a) Subcostal long-axis images showing the aorta with no separate outflow noted from the ventricles in this view, easily mistaken as a common arterial trunk (yellow solid arrow). (b) Parasternal short axis frozen image at the level of outflow tracts showing the bicuspid aortic valve and separate pulmonary arterial origin with pulmonary regurgitation and bicuspid aortic valve and absent outflow septum (yellow solid arrow). (c) Two-chamber view of right atrium and ventricle shows the absence of an infundibular portion of RV (asterisk) and opacified proximal main pulmonary artery (yellow solid arrow) is seen. (d) Outflow view of both ventricles showing hypertrophied interventricular septum and both ventricular walls and a doubly committed VSD (orange arrow) with 50% override of the aorta over interventricular septum. Ao: Aorta, PA: Pulmonary artery, LV: Left ventricle, RV: Right ventricle, VSD: Ventricular septal defect
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apc_81_22-f001
The cardiac CT showed large doubly committed VSD, with absent membranous interventricular septum [Figure 1c and d].