Fécamp, France.

The following images show a case of the pulmonary atresia with ventricular septal defect.

Images 1, 2: The image 1 shows a four-chamber view of the heart which is unremarkable except of a marked deviation of the cardiac axis to the left. The image 2 shows a long axis view of the left ventricle with an enlarged overriding aorta.

Images 3, 4: The images show a gray scale (image 3) and color Doppler (image 4) five-chamber view of the heart with an enlarged overriding aorta and a ventricular septal defect.

Images 5, 6: The image 5 represents a three-vessel view of the heart with strikingly enlarged aorta, but without any pulmonary artery. The image 6 shows a sagittal view of the aortic arch with its dilated ascending part.

Images 7, 8: The image 7 represents a color Doppler view of the ductus arteriosus (depicted in yellow) arising from the concavity of the aortic arch. Note the retrograde perfusion of the ductus arteriosus. Furthermore, no aortic collaterals can be seen. The image 8 shows the perfusion of the tortuous ductus arteriosus (in yellow) which feeds the pulmonary arteries retrogradely.

Image 9: The image shows an anterograde flow within the both main pulmonary arteries (*), that are perfused by the ductus arteriosus by retrograde way. No communication between the right ventricle and the pulmonary arteries can be seen.