PMC3282215_01
(A) The transthoracic echocardiographic parasternal short axis view shows a perimembranous VSD (arrow). (B) The color-Doppler 4 chamber view shows a VSD (arrow) with left to right shunt flow. (C) The color-Doppler subcostal view shows an intact atrial septum. VSD, ventricular septal defect; RA, right atrium; RV, right ventricle; LA, left atrium; LV, left ventricle.
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F1
Transthoracic echocardiography revealed perimembranous VSD (Fig. 1A-C), and persistent left superior vena cava draining into the RA via the coronary sinus, without bridging the left innominate vein.
PMC3282215_02
(A) The post-surgery 2-dimensional echocardiographic parasternal short axis view shows a closed VSD. (B) The 2-dimensional 4 chamber view shows both RA and RV enlargement. (C) The M-mode echocardiographic short axis, mid-ventricular view shows a paradoxical septal movement, i.e., an upward deviation of the ventricular septal wall (arrow) during the systolic phase, due to volume overload of the RV. VSD, ventricular septal defect; RA, right atrium; RV, right ventricle; LA, left atrium; LV, left ventricle.
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F2
After the operation, despite of complete closure of the VSD (Fig. 2A), she had suffered from recurrent cough, fever, and pneumonia for 3 years. The follow-up echocardiography showed both right atrial (RA) and right ventricular (RV) enlargement and right ventricular volume overload (Fig. 2B, C).
(A) Angiography of the RUPV shows a partial anomalous pulmonary venous connection, consisting of the RUPV, which drains into the RA through the SVC. (B) Chest computer tomography shows the RUPV (arrow), which drains into the SVC. RUPV, right upper pulmonary vein; RA, right atrium; SVC, superior vena cava; Ao. Aorta; PA, pulmonary artery.
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F3
ASD (Fig. 3A, B).
After partial anomalous pulmonary venous connection correction, the 2-dimensional echocardiographic 4 chamber view shows the improvement of both RA and RV enlargement. RA, right atrium; RV, right ventricle; LA, left atrium; LV, left ventricle.
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F4
At 3 years and 3 months of age, she underwent the modified Warden technique for correction of the PAPVC consisting of the right pulmonary vein connected to the left pulmonary vein. After PAPVC correction, the echocardiography showed disappearance of the right ventricular volume overload (Fig. 4).