This patient has a larger size right atrium and right ventricle. What is the cause? No obvious ASD is seen. All pulmonary veins are seen draining to LA. Then what is the cause? We commonly face this question in echocardiography lab.

Use of bubble study or agitated saline echocardiography study is a very good method to get answer, to exclude presence of ASD. These are very good and typical echocardiography videos of one of my patient. Successful device closure was performed. Kindly share your views and experiences.