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2014-03-10-09 Case of the week #367 © Bronshtein www.TheFetus.net 

 

Answer to the case of the week #367

April 17, 2014 - May 01, 2014

 

Moshe Bronshtein, MD; Segal Yeoushua, MD

Haifa, Israel.


Case report
 

Following images and videos show a case of aorto-left ventricular tunnel that was seen in a 22-week old fetus.


Images 1, 2, and videos 1, 2: 22 weeks of pregnancy; the images and videos show stenotic part of the aorta at the level of dysplastic semilunar valves and enlargement of the proximal ascending aorta (la - left atrium, LV - left ventricle, PROX ao - proximal ascending aorta). Aorto-left ventricular tunnel  - arrow. Video 2 shows color Doppler flow within the tunnel.

 

 

Images 3, 4, 5, and video 3: 22 weeks of pregnancy; the images and videos show color Doppler imaging of the stenotic part of the aorta at the level of dysplastic semilunar valves and enlargement of the proximal ascending aorta and aorto-left ventricular tunnel with reversed flow via the tunnel during ventricular diastole.

 

 


Images 6, 7, and video 4: 22 weeks of pregnancy; the images and videos show dilated ascending aorta (Ao) due to presence of the aorto-left ventricular tunnel.

 




Drawings 1, 2: The drawings show principle of the aorto-ventricular tunnel - the tunnel represents a paravalvar communication between the aorta and the left ventricle (LV) and connects the ascending aorta above the sinotubular junction to the left (most of the cases) or right ventricle.

RA - right atrium; RV - right ventricle; LA - left atrium; LV - left ventricle; Ao - aorta; PA - pulmonary artery; green arrow passes via the aorto-ventricular tunnel connecting the aorta and left ventricle.

 
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