1,3. Radiology Department, Kasr Alainy teaching hospitals, Cairo University, Egypt.
2. Fetal medicine Unit, Cairo University, Egypt.

Case report

A 32 year-old woman (G3P2) was referred to our office for routine anomaly scan. Fetal cardiac examination revealed the following findings:

• Conal ventricular septal defect with protodiastolic right to left shunting.
• Preserved obtuse angle between ascending aorta and ventricular septum with intimately attributed aortic valve to left ventricle, denoting lack of aortic overriding.
• No other additional VSDs were found.

A male baby was born and chromosomal analysis revealed normal karyotype.  Medical treatment with close observation was started for probability of spontaneous closure before taking decision of surgical correction.

Images 1, 2 and videos 1, 2: 2D and color doppler images of the left outflow tract showing the conal ventricular septal defect with diastolic right to left shunting.

Image 3, 4 video 3: 2D and doppler images showing the relation between the ventricular septal defect and the aortic valve.

Image 5, videos 4: 2D images of the fetal heart showing the left outflow tract with normal obtuse angle between ascending aorta and ventricular septu, ruled out aortic overriding.

Image 6, video 5: doppler images showing normal gross cardiac morphology.