1. Professor of obstetrics & Gynecology, Cairo University Fetal Medicine Unit.
2. Radiology department, Kasr Alainy teaching hospitals, Cairo University, Egypt.
3. Fetal medicine unit, Cairo University, Egypt.
Case report
A 26-year old woman (G2P1) with irrelevant history was referred to our institution due to suspicion of tricuspid atresia in a previous scan. Our ultrasound examination revealed revealed a tetralogy of Fallot in association with cleft of the anterior leaflet of mitral valve.
Based on the hemodynamics the occurrence of pulmonary atresia with VSD is a possibility. The association of the mitral cleft with the huge VSD which is affecting the inlet portion together with the outlet portion raised the suspicion of the partial AVSD.
However the crux was found to be normal by postprocessing of a stored STIC volume. Postnatal follow up of the fetus revealed normal karyotype and the postnatal echocardiography confirmed the integrity of the crux and the cleft of the anterior leaflet of the mitral valve.
Videos 1 and 2: Show discrepancy between both ventricles with inlet VSD in between. The aorta is overriding a malalignment VSD. Sweeping further cephalad demonstrate size discrepancy between aorta and pulmonary artery suggesting pulmonary stenosis. Also demonstrates the crux with the normal differential offset.