Subaortic stenosis associated with anomalous right ventricular muscle bundle and ventricular septal defect

A rare case of biventricular outflow tract obstruction in the form of discrete subaortic membrane and hypertrophic anomalous right ventricular muscle bundle associated with ventricular septal defect is presented.     

Right cervical aortic arch associated with a ventricular septal defect.

A patient with a right cervical aortic arch and ventricular septal defect is presented. This is the second reported case to have this rare combination of defects and the first to have survived corrective surgery. The x-ray film findings are discussed, and the similarity to the right posterior aortic arch is stressed.     

Subaortic membranous stenosis associated with infundibular pulmonary stenosis. Case report (author's transl)]

A case of combined congenital discrete subaortic stenosis and infundibular pulmonic stenosis is described. Clinical, haemodynamic data and surgical results are reported. Only one similar case has been previously described.     

Cervical aortic arch with ventricular septal defect. A differential diagnosis from interrupted aortic arch.

A case of right cervical aortic arch with a large ventricular septal defect and a bicuspid aortic valve is reported. The angiographic diagnosis was interruption of the aortic arch type II, with aberrant right subclavian artery, a closed ductus arteriosus and retrograde vertebral-subclavian flow to the descending aorta. The cervical arch, demonstrated post mortem, was located high and deep in the neck. This differential diagnosis may have potential importance, as reported experience shows that a surgical aortic anastomosis is not required in cervical aortic arch.     

Supravalvular aortic stenosis. Report of twelve cases (author's transl)

Twelve patients having supravalvular aortic stenosis were operated. Indication to the surgery was set up with a pressure gradient across the stenosis greater than 50 Hg millimeters and/or in a presence of important symptoms and/or with electrocardiographic signs of left ventricular hypertrophy. The technique and results of operation are described. The indication criteria to surgery on the basis of clinical results are discussed.     

Completely interrupted aortic arch, ventricular septal defect and patent ductus arteriosus. A complete surgical correction in one procedure (author's transl)]

The authors present a case of completely interrupted aortic arch (Type B) associated with ventricular septal defect and patent ductus arteriosus in a child 3 years and 10 months old, who was successfully subjected to complete surgical correction in one procedure. The pre- and post-operative electrocardiographic and hemodynamic data are evaluated. The authors draw attention to the extreme rarity of surgical resolution, in one procedure, of this type of congenital heart disease.     

Double aortic arch associated with coarctation, ventricular septal defect and right ventricular outflow tract obstruction. Successful surgical repair

A case of complex congenital heart disease is presented with an unusual combination of extracardiac and intracardiac anomalies. Preoperative catheterization and angiographic studies demonstrated infundibular pulmonic stenosis, ventricular septal defect and coarctation of the aorta. A double aortic arch was subsequently detected during operation.     

Ventricular septal defect associated with aortic regurgitation. Results and surgical considerations in pediatric age group (author's transl)

The Authors report their experience on the surgical treatment of ventricular septal defect and aortic regurgitation. Out of 13 patients operated upon, four required aortic valve replacement; five patients were treated with plasty of the aortic leaflets and four with the only patch closure of the V.S.D. There have not been reported hospital or late deaths. In one case, after the aortic plasty, the aortic regurgitation became severe; this patient had shown clinical signs of aortic regurgitation for more than five years before the operation. The Authors emphasize the surgical aggressiveness in this lesion when the aortic regurgitation has recently showed, whereas it is preferable to delay the operation when the aortic regurgitation has been present for more than five years.     

Congenital bilateral subclavian steal: ductus-dependent symptoms in interrupted aortic arch associated with ventricular septal defect.

There are two types of congenital bilateral subclavian steal. The first type is accompanied by severe coarctation or interruption of the aorta in which both the right and left subclavian arteries have their origin distal to the obstruction in the aorta. In most cases with complete interruption of the aorta there is a large ventricular septal defect. The second, less common type of steal is associated with isolated atresia of the proximal segment of the subclavian arteries. In the first type of steal, the anatomic predisposition for the steal is present from birth but clinical symptoms frequently do not appear until childhood or adolescence. In the newborn the presence of a widely patent duclus arteriosus and its capacity to transmit the flow and pressure from a hypertensive pulmonary artery to the descending aorta and thus to the subclavian arteries prevents cerebral symptoms and angiographic signs, but in the older infant and child, the internal diameter of the ductus has usually decreased, leading to symptoms of the subclavian steal syndrome.     

Echocardiographic features of supracristal ventricular septal defect with prolapsed aortic valve leaflet.

Anatomically diagnostic echocardiographic features of a supracristal ventricular septal defect with prolapsed right coronary aortic leaflet are described in four children aged 2 to 10 years. Both single crystal M mode as well as 80 ° phased array sector scan techniques were used. The echographic features in the M mode scan from the aorta to the left ventricle in three of four patients included (1) the position of the ventricular septal defect as a clear space between the interrupted septal echoes below the aortic root, and (2) the prolapsed right coronary aortic leaflet as anomalous linear echoes in the right ventricular outflow tract. Angiographic, intraoperative and echocardiographic contrast studies were used to establish the diagnosis.On sector scanning using the long axis view, the supracristal ventricular septal defect was recognized as a clear space between the top of the ventricular septum and the anterior segment of the aortic root in three of four patients. The right coronary aortic leaflet was seen to prolapse into the right ventricular outflow tract through this defect, and its motion could be clearly followed during systole and diastole. It is concluded that echocardiography provides anatomic diagnosis of this lesion. Furthermore, the severity and progression of this lesion can be assessed by quantitation of the left ventricular size and performance.     

Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left ventricle with outflow tract obstruction associated with a ventricular septal defect.

A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular septal aneurysm was successfully resected. This cyst, which was causing subaortic stenosis, was attached to the margin of the closed ventricular septal defect and not to the mitral valve itself nor the papillary muscle of the left ventricle.     

Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left ventricle with outflow tract obstruction associated with a ventricular septal defect.

A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular septal aneurysm was successfully resected. This cyst, which was causing subaortic stenosis, was attached to the margin of the closed ventricular septal defect and not to the mitral valve itself nor the papillary muscle of the left ventricle.