Whale's tail sign in fetus with coronary sinus total anomalous pulmonary venous connection.

Abstract

Figure S1: 4D STIC HD-live color silhouette volume rendering of the four-chamber view showing the coronary sinus TAPVC (a) and an illustrative cartoon of the ‘whale's tail sign’ were demonstrated (b). RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RPV-right pulmonary vein; LPV-left pulmonary vein; AO- aorta; SVC-superior vena cava; IVC-inferior vena cava; LBCV-left brachiocephalic vein; T-trachea; PV-pulmonary vein; RPrV-right portal vein; LPrV-left portal vein; DV-ductus venosus; UV-umbilical vein; STIC- Spatiotemporal image correlation imaging, S-spine. Figure S2: (a) 4D STIC HD-live color silhouette volume rendering of the fetal abdomen showing persistent right umbilical vein. Postnatal echocardiography: 4-chamber view (b) showing right heart dilatation and normal posterior LA space (arrow); Grayscale (c) and color Doppler (d) subcostal long axis view showing all four pulmonary veins draining directly into coronary sinus without a connecting vein and normal posterior LA space (arrow). RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RUPV-right upper pulmonary vein; LUPV-left upper pulmonary vein; RLPV-right lower pulmonary vein; LLPV-left lower pulmonary vein; AO- aorta; RHV-right hepatic vein, MHV-middle hepatic vein; LHV-left hepatic vein; IVC-inferior vena cava; DV-ductus venosus; MPV-main portal vein; SV-splenic vein; RPV-right portal vein; LPV-left portal vein; RPVI-right portal vein inferior; RPVS-right portal vein superior; RPVM-middle right portal vein, UV-umbilical vein; STO-stomach. Videoclip S1: 4D STIC High Definition-live color silhouette volume rendering of the four-chamber view showing significant ventricular disproportion and the coronary sinus TAPVC. RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RPV-right pulmonary vein; LPV-left pulmonary vein; AO-descending aorta; S-spine. Videoclip S2: The entire pathway of the coronary sinus TAPVC [whale tail sign] including all four pulmonary veins has been shown. CS-coronary sinus; 1-right upper pulmonary vein; 2-right lower pulmonary vein, 3-left upper pulmonary vein; 4-left lower pulmonary vein; AO-descending aorta. Videoclip S3: 4D STIC High Definition-live color silhouette volume rendering of the four-chamber in posterior view. The entire pathway of the coronary sinus TAPVC [whale's tail sign] has been demonstrated. RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RPV-right pulmonary vein; LPV-left pulmonary vein; AO-descending aorta. Videoclip S4: Axial bidirectional power Doppler Tomographic ultrasound imaging (TUI) of a STIC volume of the fetal heart showing the entire course (arrows) of the dilated coronary sinus significantly occupying and compressing the left atrium posteriorly. RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RPV-right pulmonary vein; LPV-left pulmonary vein; AO-aorta. Videoclip S5: Oblique sagittal view gray scale and color Doppler showing the direction of blood flow from the pulmonary veins through the coronary sinus into right atrium (left to right shunt) and the right to left shunt across the foramen ovale into left atrium from the ductus venosus. RA-right atrium; LA-left atrium; SVC-superior vena cava; HV-hepatic vein; CS-coronary sinus; PV-pulmonary vein; DV-ductus venosus. Videoclip S6: 4D STIC High Definition-live color silhouette volume rendering of the four-chamber view showing the direction of blood flow from the pulmonary veins through the coronary sinus into right atrium (left to right shunt) and the right to left shunt across the foramen ovale into left atrium. RA-right atrium; RV-right ventricle; LA-left atrium; LV-left ventricle; CS-coronary sinus; RPV-right pulmonary vein; LPV-left pulmonary vein; AO-descending aorta. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.