These echocardiograms show a ventricular septal defect located in the membranous septum just below the aortic valve. The echo density on the right ventricular side of the defect represents so-called aneurysm formation. This formation is created by fibrous tissue associated with both the right side of the defect and the tricuspid valve. This is a common mechanism for spontaneous closure of this type of defect, as the tissue continues to proliferate. The left atrium, left ventricle and muscular ventricular septum, mitral valve, aortic valve and aorta are well seen. In the real-time study in the short axis view that follows, note the motion of the aneurysm as the aortic valve opens and closes in systole and diastole.
Color flow Doppler - left-to-right shunt
This is still frame of a color flow Doppler from the parasternal short axis view. The mosaic color indicates blood flowing anteriorly into the right ventricle as it crosses the ventricular septal defect through the aneurysm formation. In the real-time study that follows, the left-to-right shunt is well seen. The mosaic pattern indicates increased velocity of flow, reflecting that left ventricular systolic pressure is significantly greater than right ventricular systolic pressure, consistent with other clinical findings that.