Late-diastolic forward flow in the aorta induced by left atrial contraction

Late-diastolic forward now is a cell-described phenomenon detectable by Dop pler echocardiography in the pulmonary trunk. It is supported by a restrict ive right ventricular diastolic function and by a low end diastolic pulmona ry artery pressure. A similar phenomenon for the left ventricle and the aor ta has not been described. We report a case of a preterm infant with aortic stenosis and endocardial fibroelastosis, who underwent balloon valvuloplas ty. Restrictive left ventricular diastolic filling led to high left atrial pressure (27 mm Hg) and a very pathologic ratio of early-to-late peak veloc ities (2.6) for an infant of 29 weeks' gestation. In combination with a low diastolic aortic pressure (24 mm Hg) caused by moderate aortic regurgitati on after intervention, a late-diastolic forward now was detectable in the a orta during left atrial contraction with pulsed Doppler echocardiography.