[Thrombosed congenital aneurysm of the membranous ventricular septum].

96 A 54-year-old man was referred to our center for assessment after an episode of syncope and progressive dyspnea. Clinical examination and echocardiography revealed dextrocardia with situs inversus, and bilateral basal crepitations without bruits. Plain chest films disclosed only an increased cardiothoracic index. Transthoracic echocardiography provided incomplete information on cardiac anatomy, and multiplanar transesophageal echocardiography was performed. Transesophageal study in a four-chamber view (A) and longitudinal view (B) confirmed situs inversus (Figure) and defined cardiac anatomy and function: atrioventricular and ventriculo-arterial discordance with intact septa and severe systemic right ventricular dysfunction (LAA indicates left atrial appendage; LA, left atrium; RV, right ventricle; LV, left ventricle). The patient had moderate tricuspid regurgitation and mildIM AG E S I N C A R D I O L O G Y