Right-to-left shunting through the unidirectional valved pat
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Abstract :
Postoperative transesophageal echocardiography images of a patient undergoing unidirectional valved patch closure of ventricular septal defect in the setting of severe pulmonary hypertension are presented. The images and videos elegantly demonstrate a functioning valve without any obstruction to the left ventricular outflow.

A 9-year-old child presented with complaints of breathlessness, poor weight gain, and history of recurrent respiratory tract infections since 1 year of age. On examination, oxygen saturation (SpO2) at rest and after the 6-min walk test was 96% and 88%, respectively. Pertinent findings on clinical examination included a palpable and loud second heart sound, a parasternal heave, and a Grade III/VI holosystolic murmur at the cardiac apex. Chest X-ray showed cardiomegaly, biventricular enlargement, a hugely dilated pulmonary artery with peripheral pruning and increased bronchovascular markings. Electrocardiogram (ECG) showed normal sinus rhythm, left axis deviation, and features of biventricular hypertrophy. Echocardiography showed a large inlet ventricular septal defect (VSD) with bidirectional shunting, mild tricuspid regurgitation, and severe pulmonary arterial hypertension. Cardiac catheterization was performed to assess operability......

http://www.annals.in/article.asp?issn=0971-9784;year=2017;volume=20;issue=2;spage=243;epage=244;aulast=Talwar
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