Right Ventricular Outflow Conduit Stenosis After Childhood Ross-Konno Procedure

Figures

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  Figure 1. Transthoracic Echocardiography (A) Pulmonic valve Doppler flow velocity (241 cm/s) in parasternal short axis view and (B) pulmonic Doppler flow in supra-aortic view (1.55 m/s), both of which show discrepancies in mean gradient and velocity. (C) Severe tricuspid regurgitation (maximal tricuspid regurgitation velocity [TR Vmax] 4.19 m/s; Bernoulli equation derived pressure gradient from the peak tricuspid regurgitation velocity [TR max PG] 70.28 mm Hg). (D) Tricuspid annular plane systolic excursion (TAPSE) of 10.5 mm suggestive of reduced right ventricular function.

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  Figure 2. Cardiac Chest Tomography Cardiac chest tomography (A) axial view showing dilated pulmonary artery (2.85 cm), (B) sagittal view showing stenosis and calcification of RV outflow/conduit (1.2 cm) with post-stenotic dilatation (2.8 cm), and (C) sagittal view showing neo-aortic diameters.

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  Figure 3. Right Heart Catheterization and Fluoroscopy Right anterior oblique view showing (A) cannulation of the coronary sinus and (B) stenosis of the right ventricular outflow/conduit (10.6 mm) and post-stenotic dilation of the pulmonary artery (29.8 mm).

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  Figure 4. Transesophageal Echocardiography (A) 35° and (B) 135° views demonstrating a functional neo-aortic root with normal aortic valve opening and no evidence of stenosis.