PMC3327021_01
Subcostal two-dimensional echocardiographic short axis view with color doppler showing a suggestion of IVC flow being directed to the left atrium
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F1
But the IVC flow could not be definitely documented draining to the RA [Figure 1].
(a) Contrast echocardiogram in apical four chamber view demonstrating initial appearance of saline contrast in the left atrium and (b) apical four chamber view demonstrating subsequent appearance of saline contrast in all chambers
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F2
It showed appearance of the contrast first in the LA and subsequent filling of all four cardiac chambers suggestive of drainage of the IVC into the LA [Figures 2a and 2b].
IVC angiogram left anterior oblique view with cranial angulation demonstrating flow of the contrast directly into the left atrium from the IVC with a small fenestration at the upper end of the patch
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F3
A contrast angiogram done in anteroposterior (AP) and left anterior oblique with cranial angulation (LAO Cr) showed the contrast entering the LA directly through the IVC and a small fenestration in the ASD patch through which the contrast filled the RA [Figure 3].