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British Heart Journal Aug 1983It is now well established that the morphology of the ventricular septal defect associated with interrupted aortic arch is such as to compromise blood flow to the...
It is now well established that the morphology of the ventricular septal defect associated with interrupted aortic arch is such as to compromise blood flow to the ascending aorta. Though there is some evidence that a similar mechanism may be operative in coarctation with ventricular septal defect, we are unaware of any necropsy study of this hypothesis. We therefore studied 25 hearts from the Heart Museum of Children's Hospital of Pittsburgh with coarctation and ventricular septal defect. Four had a malalignment defect with left ventricular outflow tract obstruction such as is seen in cases with interruption. Twenty of the remaining cases had a particular form of perimembranous defect with aortic overriding. The defects were partially closed by tricuspid valve tissue, the left ventricular outflow tract being further narrowed by various anatomical lesions. In addition, mitral valve malformations were present in 14 cases. The anatomy of the group as a whole suggests a possible reduction of aortic blood flow during fetal development. The clinical implications of these findings remain to be evaluated.
Topics: Aortic Coarctation; Heart Septal Defects, Ventricular; Heart Septum; Humans; Mitral Valve; Myocardium
PubMed: 6882605
DOI: 10.1136/hrt.50.2.176 -
British Heart Journal May 1983Cross-sectional echocardiograms of 18 neonates and infants with coarctation of the aorta and ventricular septal defect were retrospectively assessed. With a combination...
Cross-sectional echocardiograms of 18 neonates and infants with coarctation of the aorta and ventricular septal defect were retrospectively assessed. With a combination of subcostal and precordial cuts the site and anatomical relations of the defects were determined. In one case there was a muscular trabecular ventricular septal defect. Three had a malalignment defect with associated left ventricular outflow tract obstruction. In two there was a doubly committed subarterial defect with associated malalignment of the point of continuity between the aortic and pulmonary valves and the crest of the trabecular septum. Twelve cases had a perimembranous defect, with varying degrees of extension into the inlet, trabecular, or outlet septum. In this group 10 had associated aortic override, with varying degrees of left ventricular outflow tract narrowing. Abnormal insertion of the tricuspid valve was observed in 10 cases, such that it partly obscured the ventricular septal defect. Thus in most cases of coarctation with ventricular septal defect, the morphology of the ventricular septal defect and ventricular outflow tracts is such that left ventricular ejection is directed towards the pulmonary artery rather than the aorta.
Topics: Aortic Coarctation; Echocardiography; Heart Septal Defects, Ventricular; Humans; Infant; Infant, Newborn; Retrospective Studies
PubMed: 6838735
DOI: 10.1136/hrt.49.5.485 -
California Medicine Jun 1949Patients with congenital heart disease of the cyanotic type may be presumed to be candidates for surgical treatment if the examination of the heart reveals compatible...
Patients with congenital heart disease of the cyanotic type may be presumed to be candidates for surgical treatment if the examination of the heart reveals compatible findings, particularly murmurs characteristic of an interventricular septal defect, overriding aorta, and pulmonary stenosis; if the electrocardiogram shows right axis deviation; if the x-ray or fluoroscopic study demonstrates decreased pulmonary markings; if Diodrast injection shows right ventricular enlargement, a septal defect, overriding of the aorta, and small pulmonary arteries. In some cases some of these criteria may be missing. If there are not definite contraindications, exploratory thoracotomy is indicated for patients with congenital heart disease causing cyanosis.
Topics: Aorta; Cyanosis; Electrocardiography; Fluoroscopy; Heart; Heart Defects, Congenital; Heart Septal Defects, Ventricular; Humans; Hypertrophy, Right Ventricular; Lung; Male; Pulmonary Artery; Pulmonary Valve Stenosis; Thoracotomy
PubMed: 18131680
DOI: No ID Found