A multi-panel medical diagnostic and clinical series demonstrating congenital cardiovascular anomalies in a ctnnb1Δex3 model. Panels A and B are ultrasound images illustrating a Patent Ductus Arteriosus (PDA), with labels identifying the Left Atrium (LA), Aorta (Ao), Right Ventricle Outflow Tract (RVOT), and Pulmonary Artery (PA). An arrow points to the 'Open DA' (Ductus Arteriosus). Panel C provides an ultrasound view of the atrial septum with labels for the Right Atrium (RA), LA, and Ao, showing a patent foramen ovale. Panel D utilizes Color Doppler imaging to show a pathological right-to-left shunt of blood flow through the foramen ovale. Panel E is a clinical photograph of a dissected heart confirming the presence of an open foramen ovale, notable for the presence of dark pigmented cells (melanocytes) around the aperture. The collection demonstrates how failure of fetal cardiovascular shunts to close postnatally leads to abnormal circulation and chamber dilation.

This composite figure presents a detailed fetal echocardiographic evaluation at 35 weeks of gestation. Panels A and B (four-chamber views) demonstrate significant chamber disproportion, with a dilated right ventricle (RV) compared to the left ventricle (LV). The flap of the foramen ovale (FFo) appears relatively fixed and exhibits tense bulging throughout both systole (A) and diastole (B). Panel C (M-mode) confirms impaired RV contractility, showing a reduced shortening fraction compared to the LV. Panel D (three-vessel and trachea view) reveals a hypoplastic aortic arch (AoA) in comparison to the larger ductus arteriosus (DA). Panels E and F utilize color Doppler imaging to illustrate abnormal hemodynamics at the interatrial septum, characterized by turbulent blood flow (marked with asterisks) and restricted passage across the foramen ovale. These findings are clinically significant for identifying secondary cardiac changes due to fetal anemia and altered preload conditions, emphasizing the assessment of the foramen ovale and ventricular function in high-risk pregnancies.

This diagnostic image series utilizes 4D flow MRI-derived particle tracing to illustrate fetal circulatory dynamics in a ventral view. The visualization demonstrates the preferential streaming of blood from two distinct venous sources over one cardiac cycle (62 ms, 186 ms, 310 ms, and 434 ms). Red particles represent blood from the ductus venosus (DV), while blue particles represent blood from the distal inferior vena cava (IVCd). The series highlights the maintenance of separate flow streams within the proximal inferior vena cava. The red DV stream is directed preferentially through the foramen ovale (FO) toward the left ventricle (LV) to supply oxygenated blood to the systemic circulation. Concurrently, the blue IVCd stream is routed primarily toward the right ventricle (RV) for delivery to the main pulmonary artery. Anatomical landmarks labeled include the ductus venosus (DV), distal inferior vena cava (IVCd), foramen ovale (FO), right ventricle (RV), and left ventricle (LV). This pedagogical tool illustrates the physiological shunting essential for fetal development and the minimal mixing of nutrient-rich and nutrient-poor blood streams.

A composite medical illustration and graph depicting placental anatomy and related MRI biophysical properties. The left panel is a detailed anatomical diagram of a human placenta at approximately 32 weeks gestation. It illustrates the fetal circulation, including the umbilical cord (vein and arteries), chorionic plate, and the branching villous tree. The maternal circulation is shown via the basal plate, uterine spiral arteries, endometrial veins, and the intervillous space. The diagram highlights the proximity of maternal and fetal blood vessels at the exchange surface, separated by placental septa. The right panel is a bivariate plot used for diagnostic imaging analysis. The x-axis represents T2* relaxation time (ms) at 3T, a proxy for tissue oxygenation (SO2), ranging from deoxyhemoglobin to oxyhemoglobin. The y-axis represents the Apparent Diffusion Coefficient (ADC, mm²/s) on a logarithmic scale, indicating water mobility (restricted diffusion vs. active perfusion). Various placental tissue environments, such as septal walls, myometrium, and intervillous blood, are mapped onto the plot based on their specific oxygenation and diffusion characteristics, serving as a model for interpreting combined diffusion-relaxation MRI data.

This diagnostic image consists of four axial cardiothoracic CT scan slices (A-D) demonstrating complex cyanotic congenital heart disease in an adult. Panel A (four-chamber view) shows tricuspid atresia, a hypoplastic right ventricle, a large atrial septal defect (ASD), and a significantly enlarged, hypertrophic left ventricle. Panel B identifies an atretic and calcified aortic valve originating from the hypoplastic right ventricle, consistent with levo-transposition of the great arteries (L-TGA). Panel C reveals a hypoplastic ascending aorta situated anteriorly to the main pulmonary artery, with evidence of normal coronary artery anatomy. Panel D illustrates significantly dilated central pulmonary arteries, a hallmark of secondary pulmonary hypertension. The series provides an educational overview of the structural remodeling and vascular changes associated with uncorrected tricuspid atresia Type IIc, including the specific spatial relationship of the great vessels and chambers. This content is suitable for advanced medical education in cardiology and radiology focusing on congenital heart defects and their late-stage clinical manifestations.

This composite educational image illustrates the concept and clinical application of a Blalock-Taussig (BT) shunt for congenital heart disease. Panel A is a historical anatomical diagram showing the surgical connection between the subclavian arteries (SCA) and the right and left pulmonary arteries (RPA, LPA) arising from the ascending aorta (AAo). This represents the classic palliative procedure intended to increase pulmonary blood flow. Panel B is a cineangiographic frame demonstrating a modified Blalock-Taussig anastomosis in a clinical setting. It shows a Gore-Tex graft (GG) connecting the left subclavian artery (LSA) to the pulmonary artery (PA). The angiography reveals a patent, wide-open anastomosis with robust contrast opacification of the pulmonary artery, confirming successful systemic-to-pulmonary shunting. This visual material is used to teach surgical management of cyanotic heart defects, such as Tetralogy of Fallot or pulmonary atresia, where increasing pulmonary perfusion is critical for patient stabilization.

This dual-panel image illustrates surgical approaches for augmenting pulmonary blood flow in cyanotic heart disease. Panel A is a historical anatomical diagram showing the classic Blalock-Taussig shunt, depicting the end-to-side anastomosis of the subclavian arteries (SCA) to the right (RPA) and left (LPA) pulmonary arteries, respectively, branching from the ascending aorta (AAo). Panel B is a clinical diagnostic image consisting of a selective cine-angiogram frame demonstrating a modified Blalock-Taussig (mBT) shunt. It shows a tubular, radio-opaque Gore-Tex graft (GG) originating from the region of the left subclavian artery (LSA) and connecting inferiorly to a widely patent pulmonary artery (PA). This comparison highlights the evolution from direct arterial anastomosis to the use of synthetic interposition grafts to increase pulmonary perfusion. The material is relevant for pediatric cardiology and cardiothoracic surgery education regarding palliative procedures for complex congenital heart defects.

A grayscale two-dimensional (2D) echocardiogram image illustrating complex congenital heart disease anatomy, specifically Tetralogy of Fallot (TOF) associated with pulmonary atresia and a patent ductus arteriosus (PDA). The image shows the aortic arch (AA) superiorly and the descending aorta (AO). Key cardiac structures are labeled, including the right ventricle (RV), left ventricle (LV), and a prominent ventricular septal defect (VSD) indicating an interventricular communication. The pulmonary artery (PA) is visualized originating from the undersurface of the aortic arch, characteristic of ductal-dependent pulmonary circulation in the setting of pulmonary atresia. This diagnostic image demonstrates the spatial relationships between the great vessels and the ventricles required for the clinical management of cyanotic congenital heart defects in pediatric patients. Labels present: AA (Aortic Arch), AO (Aorta), PA (Pulmonary Artery), VSD (Ventricular Septal Defect), LV (Left Ventricle), and RV (Right Ventricle).

This composite of transthoracic echocardiographic (TTE) images displays key diagnostic features of Tetralogy of Fallot (TOF). The 2D grayscale images (A, B, E) identify a large malalignment-type ventricular septal defect (VSD, red arrows) and an overriding aorta (Ao) positioned over the interventricular septum. Image B, a parasternal short-axis view, further highlights a hypoplastic main pulmonary artery (blue arrow). Image D, an apical four-chamber view, shows a moderately dilated and hypertrophied right ventricle (RV) compared to the left ventricle (LV). Functional assessment via Continuous Wave Doppler (C) demonstrates severe right ventricular outflow tract (RVOT) obstruction with a peak velocity (Vmax) of 6.3 m/s, indicating a high pressure gradient. Image F uses Color Doppler to visualize bidirectional shunt flow across the VSD. This set illustrates the classic anatomical components of TOF: VSD, overriding aorta, RVOT stenosis/pulmonary hypoplasia, and subsequent RV hypertrophy, providing a comprehensive pedagogical overview of cyanotic congenital heart disease imaging.

This diagnostic image consists of two panels (A and B) showing Cardiac Magnetic Resonance Imaging (MRI) in a patient with Tetralogy of Fallot. Panel A presents an axial view demonstrating a large ventricular septal defect (VSD) and an overriding aorta, where the aortic root is positioned directly above the septal defect rather than solely over the left ventricle. Panel B provides a sagittal/oblique view highlighting significant right ventricular hypertrophy, characterized by thickened muscular walls of the right ventricle. Additionally, this view illustrates subpulmonary stenosis, visible as an anatomical narrowing of the right ventricular outflow tract (RVOT) below the pulmonary valve. These findings represent the classic morphological components of Tetralogy of Fallot, a cyanotic congenital heart disease. The images serve as an educational example of how cardiac MRI can definitively characterize complex intracardiac shunts, valvular obstructions, and ventricular remodeling for surgical planning.

This composite figure presents multi-modal cardiac imaging of a patient with Tetralogy of Fallot. Panels (a) through (d) utilize transthoracic echocardiography: (a) Parasternal long-axis view showing a large subaortic ventricular septal defect (VSD, white arrow) with an overriding aorta. (b) Color Doppler confirms bidirectional shunting across the VSD. (c) Apical four-chamber view demonstrating marked right ventricular (RV) hypertrophy. (d) Spectral Doppler showing significant RV outflow tract (RVOT) obstruction with a high-velocity jet of 4.9 m/s. Panels (e) and (f) display Cardiac Magnetic Resonance Imaging (CMRI): (e) 4-chamber cine image used for volumetric analysis showing RV enlargement. (f) Detailed CMRI of the RVOT (yellow arrow) identifying severe infundibular (subvalvular) pulmonary stenosis. Collectively, these images illustrate the classic anatomical components of Tetralogy of Fallot including VSD, overriding aorta, RV hypertrophy, and RVOT obstruction, emphasizing the importance of multimodality imaging in assessing congenital heart disease.