Left ventricular non-compaction associated with bicuspid aortic valve and aortic coarctation

Male 18 years old, who began with data of heart failure. The transthoracic echocardiogram showed severe tricuspid regurgitation and pulmonary hypertension with sPAP of 90 mmHg, bicuspid aortic valve (BAV) with moderate aortic regurgitation, and juxtaductal aortic coarctation. On physical examination, a cardiac apical impulse was palpated, near the midclavicular line in the sixth left intercostal space. I sound was duplicated by click aortic opening, II sound with physiological splitting and reinforced, aortic systolo-diastolic murmur and a mitral rumble was heard. The peripheral pulses were googly. An interventional treatment of aortic coarctation was performed with Palmaz stent and the patient was kept on medical treatment. In the follow-up, the last echocardiographic study showed severe aortic regurgitation and left ventricular hypertrabeculations with noncompacted/compacted ratio