• Hypoplastic Left Heart Syndrome (HLHS)
    • Restrictive atrial septum which bows towards the right atrium
    • Dilated pulmonary veins
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Restrictive atrial septum which bows towards the right atrium
    • Only a small amount of turbulent left to right shunting (blue flow) is noted across the atrial septum
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Restrictive atrial septum which bows towards the right atrium
    • Only a small amount of left to right shunting (red flow) is noted across the atrium septum
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Restrictive atrial septum which bows towards the right atrium
    • Only a small amount of left to right shunting (red flow) is noted across the atrium septum
    • Flow reversal noted in the pulmonary veins suggestive of a restrictive atrial septum
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Dilated pulmonary veins in fetus with a restrictive atrial septum
    • The atrial septum bows towards the right atrium
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Spectral Doppler acoss the PFO in fetus with restrictive atrial septum
    • Demonstrates a restrictive flow pattern with a mean gradient of ~6 mmHg
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Spectral Doppler in a pulmonary vein in fetus with restrictive atrial septum
    • Pulmonary vein flow reversal is noted (flow above baseline)
    • Forward to reverse VTI ratio is ~2.8 (9.6/3.4) consistent with a restrictive atrial septum
      • Forward to reverse VTI ratio <3 considered to be restrictive
  • Hypoplastic Left Heart Syndrome (HLHS)
    • Spectral Doppler in a pulmonary vein in fetus with restrictive atrial septum
    • Flow reversal in the pulmonary vein is noted (flow below baseline)
    • Forward to reverse VTI ratio is ~1:1 consistent with a severely restrictive atrial septum
      • Forward to reverse VTI ratio <3 considered to be restrictive
This is HLHS atrial septum