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Transcript of the video: Closure line of aortic valve on M-Mode echocardiogram, is seen as central line, while in bicuspid aortic valve, it is an eccentric closure, nearer to one of the walls of the aorta. This eccentricity of closure of the aortic valve leaflets, can be calculated using what is known as eccentricity index.
The striking finding is the huge enlargement of the right pulmonary artery, almost aneurysmal dilatation of right pulmonary artery. Main pulmonary artery is also grossly dilated. And you can see left pulmonary artery shadow and rest of it is not seen here. This is the aortic knuckle. This could be an end on view.
Transcript of video: Hypoplastic Left Heart Syndrome is a very severe form of congenital heart disease, in which, the left ventricle, aorta and mitral and aortic valves are hypoplastic and valves may be atretic as well. A Gore-Tex tube is used and this maintains, this is a Blalock-Taussig shunt, which maintains pulmonary circulation.
This is the schematic diagram of the heart in which you can see right atrium, right ventricle, left atrium, left ventricle, aorta and pulmonary artery. Unlike the valves on the left side like the mitral and aortic, right sided valves can have some leak. Similarly, another right sided valve is the pulmonary valve.
Normally, the main pulmonary artery segment will be concave and left atrial appendage region also will be not prominent. So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. Those are not very clear in this picture.
This is the aortic valve in closed position and mitral valve also appears to be closed in position. You can also see the aortic override. So, when there is an aortic override, if the override of the aorta is less than 50%, you think of tetralogy of Fallot. Separation between the attachments of the aortic and mitral valve.
Transcript of the video: Eisenmenger syndrome is an important complication of large left to right shunts which develop later due to development of pulmonary vascular obstructive disease and severe pulmonary hypertension. So in ASD Eisemenger, suprasystemic pulmonary hypertension is possible. But, leave that alone.
That is, right ventricle is connecting to aorta, and left ventricle to pulmonary artery. That is, pulmonary artery is transposed over to the right ventricle, and aorta over to the left ventricle, so that normal anatomy is restored. In dextro transposition of great arteries or D-TGA, there is ventriculoarterial discordance.
Leaving a fenestration in the interatrial septum during a Fontan repair is useful in relieving the central venous congestion when pulmonary blood flow is driven by venous pressure in Fontan repair. They noted that benefit was more pronounced if mean pulmonary arterial pressure was 13 mm Hg or more, as expected.
So it will not produce a true LV to aorta pullback tracing, which is required in cases like aortic stenosis. While standard pigtail catheter is mainly used on the left side, Grollman PA is a catheter used for pulmonary angiography, on the right side. When the tip is in the left ventricle, this region will be in the aorta sometimes.
Usual structures imaged in this view are the right ventricular free wall and outflow region, interventricular septum, aorta, and aortic valve, left ventricular outflow tract, anterior and posterior mitral leaflets, left ventricular cavity, posterior wall of left ventricle and left atrium. Colour flow shows the flow in pulmonary artery.
One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. You can see the ventricular septal defect and aortic over ride. Pulmonary stenosis, which is usually right ventricular outflow tract stenosis.
I has to be done quite early in life before the left ventricular muscle mass regressed due to the lower load of the pulmonary circulation. Rare long term problems include narrowing of the pulmonary artery and aortic regurgitation due to aortic root enlargement.
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