Right Ventricular Outflow Tract Obstruction in Monochorionic Twins with Selective Intrauterine Growth Restriction

Figure 2

(a) Depicts the stenosis of the pulmonary valve during contrast injection into the right ventricle (RV) obtained during cardiac catheterization. Note the very small opening of the pulmonary valve (arrow). (b) Shows an apical 4-chamber view obtained with echocardiography. Note the echogenic hypertrophied trabeculae within the cavum of the RV. (c) Shows the continuous wave Doppler tracing along the main pulmonary artery with a peak gradient of 12 mmHg. Furthermore, the end diastolic forward flow over the pulmonary valve is clearly depicted (*) as a sign of restrictive RV filling. LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle.