What is this? #2

1 IE into RA

The colour flow

2 AV short twin

  • The diagnosis should be quite apparent
  • Here are more views

3 AP4

4 AV zoom

5 AV SAX

  • This view shows the vegetation extending from the aortic valve into the tricuspid valave
  • It also shows the fistula connecting the aortic root to the RVOT
  • Thus the earlier colour flow mapping shows a shunt from the aortic root into the RVOT
  • The following shows this in different angle

6 AV long twin

 
From the 30 degree view

 
Conclusion

  • This patient has an aortic infective endocarditis with large vegetation attached to the NCC
  • However, all the cusp have been compromised with resultant severe AR
  • The vegetation has also caused a fistula into the RVOT as well as the Tricuspid inflow
  • Patient was treated with anti-biotic with a view to surgical intervention
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