Figure 1

From the ME AV LAX view, right coronary cusp of aortic valve can be easily figured while RCA is seldom visualized (A). However, the abnormal RCA-to-PA fistula of this patient was observed (diameter = 0.4 cm) because of the proximity of the fistula to the RCA origin (B). Mid-esophageal aortic valve long axis-view. NCC: noncoronary cusp, RCC: right coronary cusp, RVOT: Right ventricular outflow tract, RCA: right coronary artery, PA: pulmonary artery.