PMC7325629_01
Bedside electrocardiogram revealed ST segment elevation.
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F1
The bedside electrocardiogram showed pathological Q wave and ST segment elevation (Figure 1).
Emergency bedside transthoracic echocardiography revealed funnel shaped M-VSD (A). The white arrows indicate the left and right ventricular shunt orifice (A,B). Color Doppler flow imaging show a bidirectional shunt between the left and right ventricles (A,B). LA, left atrium; RA, right atrium; LV, left ventricle; RV, right ventricle.
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F2
The diameters of the left and right ventricular shunt orifice were 10 and 5 mm, respectively (Figures 2A,B). Color Doppler flow imaging showed a bidirectional shunt between the left and right ventricles (Figures 2A,B), and also revealed severe mitral regurgitation (Figure 3A), and mild pulmonary hypertension (Figure 3B).
Color Doppler flow imaging revealed severe mitral regurgitation (A), and mild pulmonary hypertension was estimated by continuous-wave doppler (B). Opposite the muscular ventricular defect, a ventricular aneurysm on the left ventricular posterior wall was formed (C), indicated by the arrow.
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F3
Color Doppler flow imaging showed a bidirectional shunt between the left and right ventricles (Figures 2A,B), and also revealed severe mitral regurgitation (Figure 3A), and mild pulmonary hypertension (Figure 3B). Opposite of the muscular ventricular defect, it was noted that a ventricular aneurysm on the left ventricular posterior wall had formed (Figure 3C).
Transthoracic echocardiogram showed no residual shunt after operation, and the arrow indicates the occluding device.
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F4
Both immediate trans-esophageal and trans-thoracic echocardiogram showed no residual shunt after operation (Figure 4).