Postoperative Normalization of Left Ventricular Noncompaction and New Echocardiographic Signs in Aorta to Left Ventricular Tunnel

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Abstract

We report postoperative normalization of left ventricular noncompaction in a neonate undergoing successful neonatal surgery for type II aorta to left ventricular tunnel (ALVT) associated with a large patent ductus arteriosus, floppy and extremely redundant anterior mitral leaflet, right coronary artery arising directly from the tunnel, and severe left ventricular noncompaction. We also described 2 novel echocardiographic findings in ALVT including “triple wavy line sign” on M-mode echocardiography which disappeared 1 month after operation and “abnormally increased left ventricular posterior wall motion” on M-mode of standard parasternal long-axis view on color tissue Doppler imaging (TDI) that also normalized postoperatively. We showed that proper definition of endocardial border is extremely important in strain and strain rate imaging in the context of left ventricular noncompaction. Preoperative longitudinal strain and strain rate were significantly decreased in comparison to radial strain and strain rate. Circumferential strain and strain rate were normal. (Echocardiography 2013;30:E102-E107).

Mini-Abstract

We report postoperative normalization of non-compaction in a neonate undergoing successful neonatal surgery for type II aorta to left ventricular tunnel (ALVT) associated with a large patent ductus arteriosus, floppy and extremely redundant anterior mitral leaflet, right coronary artery arising from the tunnel and severe left ventricular noncompaction. We also described 2 novel echocardiographic findings in ALVT including “triple wavy line sign” on M-mode echocardiography which disappeared one month after operation and abnormally increased left ventricular posterior wall motion on M-mode imaging of standard parasternal long-axis view on color tissue Doppler imaging (TDI) that also normalized postoperatively.

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