The most closely guarded secret.The Enigma

[Wojtek Guzowski]

15 yo asymptomatic boy.challenging for a basketball player. Standard projections-> scans from SSN- suprasternal notch.Isolated anomaly- has anyone ever never seen this anomaly from an Orphanet domene? Described in Nanda book

[Wojtek Guzowski]

Next clips.I have seen this anomaly two times ia adolescents only, one boy and a girl.

[Wojtek Guzowski]

images.Ended

[Aleksandr]

Этот синий поток в просвете легочной артерии, я правильно понял? Тогда это, вероятно, коронаро-легочная фистула.

[Wojtek Guzowski]

Do you mean CAF,coronary artery to >Pulmonary artery fistula? Standard projection from supraclavicular notch to recall. the meritum: the Blue jet.
The best way to visualize is neither CT or CMR,but TTE.TEE is a second line imaging.

In differentiating diagnosis: atypical PDA or PDA associated with right aortic arch, aberrant right subclavian artery,very rare emanation of coronary artery to right pulmonary artery fistula or anomalous LCx from right pulmonary artery(ALCxRPA) analogical to ALCAPA/ LMCA from Pulmonary artery/
But there is something else on images.What?
Feel free to shoot))))
This case is from 2017, two days ago I have seen the second one,now I know.
But the first time there was no one to tell me what that was.

[Wojtek Guzowski]

Here is a newest patient,a day before yesterday moning.Unfortunately I have missed a movie,only a still with a trace of Blue jet and PW doppler,from aortic arch.

[sokolov166]

Это очень интересно. В большинстве случаев проблем нет в диагностике да и тактике. даже с небольшим протоком можно неплохо жить если камеры не увеличены.

[Wojtek Guzowski]

It is a trivia with no after-effects.I have found the solution in second volume Navin Nanda "Echocardiography.." on a page 1772.
Do you want to see an image with schema from N.Nanda book or somebody is to know this imponderabillium?

[sokolov166]

will you want to placed it in here? do it)

[Wojtek Guzowski]

Yes,of course like I always do. Schema TTE and TEE from Navin Nanda book.
The rest movie is mpg format,how to add?

[Wojtek Guzowski]

Can anybody help to attach mpg format movie?

[AOkhotin]

Hello, Wojteck!

You can send it to me by email () or thru the cloud. I will convert it to attachable format.

[Wojtek Guzowski]

Thx a lot
I have sent movie clips to dr Okhotin.

[Wojtek Guzowski]

The same anomaly from Navin Nanda,relevant movies: TTE and TEE

[Wojtek Guzowski]

The name of the game is APAF- acronym.To be axact: a second type of APAF.