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2001-10-01-10 Double inlet single ventricle with transposition of the great arteries © Martinez www.thefetus.net/

Double-inlet single ventricle with transposition of the great arteries

Raul Martinez, MD

Unidad Regiomontana de Diagnostico, Monterrey, Nuevo Leon, Mexico

This is a second trimester fetus with a Double inlet single ventricle with transposition of the great arteries.

"Four-chamber" view (actually three chambers !)
Same in systole
Real time color Doppler of the four-chamber view during ventricular systole that shows left and right atrium, foramen ovale, and one single ventricle.
Real time color Doppler of the four chamber view during end ventricular diastole showing that there is no interventricular septum. (RA = right atrium, LA = left atrium, SV = single ventricle) 
Real time color Doppler of the four chamber view during ventricular diastole showing one single ventricle and the presence of mitral and tricuspid valves. 
Real time color Doppler of the three vessel view with the settings of flow velocity of the ultrasound equipment very low, so it could show every vessel on this view. (Ao = ascending Aorta, DA = descending aorta,  PA = pulmonary artery; LPA = left pulmonary artery). Although limits between pulmonary artery and ascending aorta are not so clear, the ascending aorta is arising in front and to the left of the pulmonary artery. There is a short video that corresponds to this picture.
This image is at a level a little bit caudal to the following one.

The ascending aorta is seen transversally and in front and to the left of the pulmonary artery, which is seen longitudinally. This is more visible on the video.

Transducer perpendicular to the long axis of the fetal thorax on the aortic arch view showing the ascending aorta coming from the left. There is a short video that corresponds to this picture.
Three vessel view showing the ascending aorta located in front and to the left of the pulmonary artery, instead of the normal location between pulmonary artery and superior vena cava. (Note that the baby has turned 90 counter-clockwise compared to the other pictures in this series). Although there seems to be continuity between ascending aorta and pulmonary artery, the video helps to recognize the limits and trajectory of these vessels.
This short axis view and video demonstrate that the aorta is not in the usual location. 

 

 

There are also several videoclips:

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