Congenital Left Ventricle-to-Pulmonary Artery Fistula Wen-Pin Hung, Jieh-Neng Wang, Hok-Keong Chang, Ta-Jung Chung, Yi-Shan Tsai,

and Jing-Ming Wu J. Am. Coll. Cardiol. 2010;55;166 doi:10.1016/j.jacc.2009.03.094

This information is current as of July 28, 2011

The online version of this article, along with updated information and services, is located on the World Wide Web at: http://content.onlinejacc.org/cgi/content/full/55/2/166

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Journal of the American College of Cardiology 2010 by the American College of Cardiology Foundation Published by Elsevier Inc.

Vol. 55, No. 2, 2010 ISSN 0735-1097/10/$36.00 doi:10.1016/j.jacc.2009.03.094

IMAGES IN CARDIOLOGY

Congenital Left Ventricle-to-Pulmonary Artery Fistula

Wen-Pin Hung, MD,* Jieh-Neng Wang, MD,* Hok-Keong Chang, MD, Ta-Jung Chung, MD, Yi-Shan Tsai, MD, Jing-Ming Wu, MD* Tainan, Taiwan

From the Departments of *Pediatrics and Radiology, National Cheng Kung University Hospital, and Department of Pediatrics, Sin-Lau Hospital, Madou Branch, Tainan, Taiwan. Manuscript received March 13, 2009, accepted March 25, 2009.

n 11-month-old girl presented with tachypnea and a grade 3/6 systolic heart murmur on her physical examination when receiving a scheduled vaccination. Chest radiography showed cardiomegaly and increased lung markings. Transthoracic color Doppler echocardiography showed a type-2 atrial septal defect and an abnormal turbulent ow from the lateral wall of the left ventricle (LV), but both coronary arteries appeared normal. Cardiac catheterization was performed that revealed 2 oxygen-saturation step-ups, 1 at the right ventricle (from 62% to 85%) and the other at the pulmonary artery (PA) (from 85% to 87%), with a total Qp/Qs of 3.5. An angiogram of the LV showed 2 stulas originated from the lateral wall of the LV and then joined together to drain into the posterior-lateral side of the PA (A, Online Video 1). An aortogram showed a normal pattern of coronary arteries. A cardiovascular computed tomography scan also conrmed abnormal communication between the LV and PA (B). The white arrows in B indicate the abnormal LV-to-PA stula.

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Congenital Left Ventricle-to-Pulmonary Artery Fistula Wen-Pin Hung, Jieh-Neng Wang, Hok-Keong Chang, Ta-Jung Chung, Yi-Shan Tsai, and Jing-Ming Wu J. Am. Coll. Cardiol. 2010;55;166 doi:10.1016/j.jacc.2009.03.094 This information is current as of July 28, 2011
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