Left Ventricle to Right Atrial Shunt Associated with Ventricular-Atrial Malalignment, Double Outlet Right Atrium, and Subaortic Membrane.

We describe an asymptomatic 7 year old boy who was taken to the operating room for repair of a subaortic membrane and possible Gerbode's defect. He was found to have a double outlet right atrium associated with an accessory atrioventricular valve in addition to a small atrial septal defect and subaortic membrane. Regurgitant flow through this accessory valve led to the left ventricle to right atrial shunt that was seen on pre-operative ECHO. The atrial septal defect was repaired and a baffle was used to isolate blood flow across the accessory valve from the left atrium to the left ventricle. The patient was discharged on post-operative day 4 and has been doing well two years post-operatively.