Live Three‐Dimensional Transthoracic Echocardiographic Demonstration of Septal Perforator Coronary Artery–Left Ventricle Fistulas Following Myectomy

We present an adult patient with hypertrophic cardiomyopathy status post septal myectomy in whom live three‐dimensional transthoracic echocardiography (3D TTE) demonstrated two septal perforator coronary arteries opening directly into the left‐ventricular outflow tract. Only one of these fistulas could be demonstrated by two‐dimensional transthoracic echocardiography (2D TTE). Our case demonstrates the potential usefulness of 3D TTE as a supplement to 2D TTE in the assessment of septal coronary artery–left ventricle fistulas.

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