Case of the Week # 524

Lusine Karapetyan

September 17, 2020 - October 8, 2020

City hospital named after E.O.Muhin, Moscow ,Russia

25 year old G1P0 with unremarkable personal and family history was sent to our unit for the second trimester scan at 19 weeks pregnancy.

The first trimester screening  was reported to be normal.

We obtained following images and videos.

Images 1-2, videos 1-4

1
Image 2

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Answer

25 year old G1P0 with unremarkable personal and family history was sent to our unit for the second trimester scan at 19 weeks pregnancy. The first trimester screening was reported to be normal.

We obtained the following images and videos showing atrioventricular and ventriculoartrerial discordance i.e. the right ventricle lied on the left side and vice versa. There was a moderator band on the left side and the lumen of the left side was shorter than right side.

Image 1
Image 1

In the video 1:
-the tricuspid valve's papillary muscles(located on the left side) were attached to the heart's apex and septum.
-the mitral valve's papillary muscles (on the right side) were attached to the lateral wall of the morphological left ventricle (located on the right side).

Videos 2-4 showed that the aorta arised from the left-sided (morphologically right) ventricle and that the pulmonary artery arised from the right-sided (morphologically left) ventricle.

Our diagnosis was therefore congenitally corrected transposition of the great arteries (ccTGA), which was confirmed after birth.

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