Echo Case 137: Unique Imaging Finding in Transplanted Heart

A patient who had cardiac transplantation and has undergone multiple right ventricular, endocardial biopsies. Spot the findings shown in these echocardiography clips and make a diagnosis. The answer will be shown after 1 min.

Case 137 Answer: In apical four chamber view there is a turbulent flow near the apex, M Mode and Continuous wave doppler confirmed high velocity flow through out the cardiac cycle.So its an Iatrogenic Coronary Artery to Right ventricular Fistula. which is a Common complication due to multiple biopsies after heart transplant.

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