Communication Between Distal Ascending Aorta and Adjacent Superior Vena cava

Volume 2, Apr 2013

Sita Ram Mittal, MD, DM, Ajmer, India

A two months old child was refered for echocardiography for tachypnea. Echocardiography revealed mid systolic reduction in pulmonary artery flow (Figure 1A), severe pulmonary artery hypertension (right ventricular systolic pressure of 89.3 mmHg calculated from tricuspid regurgitation jet), dilated right atrium and right ventricle and a small (4.5 mm) ostium secundum atrialseptal defect with right to left shunt (Figure 1B). Supra sternal view with colour Doppler revealed a turbulent jet in superior vena cava which was arising from distal ascending aorta near the beginning of aortic arch (Figure 1C). Pulsed wave Doppler confirmed continuous flow between aorta and superior vena cava (Figure 1D). Parents did not agree for CT angio or catheterization.