PAIVS - Other examples

This study demonstrates pulmonary atresia with an intact ventricular septum (membranous component). The pulmonary valve is trileaflet with a normal annulus, but no opening is visualized, and there is no pulmonary regurgitation. Branch pulmonary artery dimensions are normal, although Doppler shows mildly elevated velocities, with peak gradients of 12 mmHg in the right pulmonary artery and 13 mmHg in the left. An atrial septal aneurysm is present, along with a small secundum ASD measuring 0.3 cm with predominantly right-to-left shunting. There is mild-to-moderate tricuspid regurgitation, with a right ventricle–to–right atrium gradient of 118 mmHg. The tricuspid valve is mildly hypoplastic with restricted leaflet motion and a mean inflow gradient of 4.6 mmHg. The right ventricle is non-apex forming, tripartite, and moderately hypoplastic, but its systolic function appears grossly normal, as does left ventricular systolic function. Coronary origins are normal and no coronary sinusoids are visualized (although catheterism is required to rule out a right ventricular coronary perfusion). A large, nonrestrictive, tortuous PDA measuring 0.50 cm provides left-to-right shunting in diastole with a peak gradient of 28 mmHg, and diastolic flow reversal is noted in the descending aorta.

Fetal Images