case_images: PMC6450239_01
case_images: (a) TEE: systolic color flow shunt between the LVOT and the RA. (b) 3DE: LVOT perspective en face of Gerbode defect (white arrow); (c) 3DE right atrium perspective en face of Gerbode defect (white arrow); (d) 3DE color Doppler: tricuspid regurgitation and LV-to-RA shunt. LA = Left atrium, RV = Right ventricle, RA = Right atrium, LVOT = Left ventricular outflow tract, TEE = Transesophageal echocardiography, 3DE = Three-dimensional echocardiography
case_images: JCE-29-14-g001.jpg
case_images: PMC6450239_01_JCE-29-14-g001.jpg
case_images: F1
case_images: A postprocedural transesophageal echocardiography (TEE) showed an abnormal color flow during systole between the left ventricular outflow tract (LVOT) and the right atrium (RA) [Figure 1a, white arrow]. 3DE allowed a detailed anatomical imaging of the shape and the location of a small (size 0.4 cm x 0.5 cm), circular, atrioventricular, defect that was a type II, direct, supravalvular, Gerbode-type defect, from both the LVOT [Figure 1b, white arrow] and RA views [Figure 1c, white arrow] of the membranous atrioventricular septum with perspective en face. 3D color Doppler echocardiography [Figure 1d and Video 1] clearly allowed to distinguish the left-to-right shunt (black arrow) from the tricuspid regurgitant jet (yellow arrow) and the leaflets of tricuspid valve (white arrows).