Abstract

We describe the color flow Doppler appearances of an unusually directed jet of pulmonic valve regurgitation in a patient who has had surgery for aortic root dissection. This jet was bluish on color flow Doppler (away from transducer) and diastolic in timing, with peak velocity 1.8 m/sec; it originated at the point of apposition of the pulmonic cusps. These features served to distinguish the jet from that due to an iatrogenic aortic root-right ventricular fistula. We speculate that the pulmonary trunk was so distorted during surgery on the ascending aorta as to alter alignment of the pulmonic valve cusps, resulting in the unusual direction of the regurgitant jet.

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