PMC6450236_01
Parasternal long-axis view, M-Mode: left ventricle has normal diameters and normal thickness; interventricular septum has paradoxical movement; right ventricle is dilated
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F1
Transthoracic echocardiography showed normal left ventricular chamber size and wall thicknesses (end-diastolic diameter 48 mm, interventricular septum 10 mm, and posterior wall 9 mm) [Figure 1] and normal systolic function (Simpson rule ejection fraction 60%); right ventricle was dilated (basal diameter 46 mm) [Video 1] with preserved longitudinal systolic function (TAPSE 24 mm, S': 12 cm/s).
Apical four-chamber view, Color-Doppler: atrial septum has a width shunt; interventricular septum seems to have a close shunt
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F2
Color-Doppler showed a significant left-to-right shunt both at interatrial and interventricular septum [Figure 2], and moderate mitral valve regurgitation was present probably due to a cleft in the anterior leaflet [Figure 3]. It demonstrated: A 25 mm ostium primum defect with hemodynamically significant left-to-right shunting, a "cleft" in the anterior leaflet leading to moderate regurgitation of AV valve, a restrictive small ventricular septal defect [Figures 4,5 and Videos 2,3].
Parasternal short-axis mitral valve level: it shows a "cleft" of anterior leaflet (arrow)
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F3
Color-Doppler showed a significant left-to-right shunt both at interatrial and interventricular septum [Figure 2], and moderate mitral valve regurgitation was present probably due to a cleft in the anterior leaflet [Figure 3].
Transesophageal echocardiography four-chamber view, color-Doppler: ostium primum atrial septum defect (25 mm) with significant left-to-right shunt; high-velocity flow is evident at left atrioventricular leaflet level
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F4
It demonstrated: A 25 mm ostium primum defect with hemodynamically significant left-to-right shunting, a "cleft" in the anterior leaflet leading to moderate regurgitation of AV valve, a restrictive small ventricular septal defect [Figures 4,5 and Videos 2,3].