Figure 51-5 A, Echocardiogram with a Doppler flow map in the long-axis view illustrating a residual ventricular septal defect (VSD) resulting from patch dehiscence after initial repair. Turbulent flow through the VSD appears as a mosaic of white particles (arrow). This finding necessitated immediate reinstitution of cardiopulmonary bypass and re-repair. B, Repeat Doppler flow map in the long-axis view illustrates patch closure (arrow) of the VSD after re-repair. Note the absence of turbulent flow with the loss of the mosaic of white particles.; Ao, aorta; LA, left atrium; LV, left ventricle; RV, right ventricle.