Figure 1.

Progressive Isolation of the Apical Chamber of the RV

Transthoracic 40chamber view (4CV) performed in 2013 showing a restrictive jet in (A) color Doppler and (B) continuous Doppler between the apical and the proximal right ventricle (RV) chambers. In A, there are 2 color signals: the transtricuspidal flow (asterisk) and the flow between the high- and low-pressure chamber (arrow). (C, D) The 2021 transthoracic 4CV and short-axis view showing the complete isolation of the apical chamber from the rest of the RV, communicated with the left ventricle (LV) by a wide apical muscular ventricular septal defect (VSD) with no restrictive gradient between them. (E) The 2021 cardiac magnetic resonance 4CV confirming the isolation of the right apical segment, now fully connected to the LV. AC = apical chamber; RA = right atrium.