Cleft on the left: imaging appearance on dual-source CT

Description 

A 30-year-old man was presented to the cardiology outpatient department with complains of easy fatigability and recurrent chest infections since childhood. There was no history of cyanosis, palpitations or effort intolerance. Chest radiograph was unremarkable. Transthoracic echocardiography (ECHO) showed ostium primum atrial septal defect (ASD), trifoliate mitral valve (MV) with mitral regurgitation and presence of two papillary muscles. Cardiac CT was done using a third-generation dual-source 192-slice CT system (SOMATOM Force, Siemens Healthcare, Forchheim, Germany) to look for extracardiac vascular anatomy as part of preoperative workup. It clearly demonstrated the partial atrioventricular septal defect (ostium primum ASD without any shunt at the level of ventricles) with anterior MV cleft (figure 1A,B). CT findings corroborated with the ECHO findings (figure 1C, D). No other associated malformations were seen. The patient is now planned for direct suturing of mitral valve cleft with concomitant mitral annuloplasty and...

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