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(Circulation. 1963;27:494.)
© 1963 American Heart Association, Inc.

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Accessory Valvular Tissue Causing Subpulmonary Stenosis in Corrected Transposition of Great Vessels

MORRIS J. LEVY M.D.¹; C. WALTON LILLEHEI M.D.¹; LARRY P. ELLIOTT M.D.¹; LEWIS S. CAREY M.D.¹; PAUL ADAMS JR. M.D.¹; JESSE E. EDWARDS M.D.¹

¹ From the Departments of Surgery, Pediatrics, Radiology, and Pathology, University of Minnesota, Minneapolis, Minnesota, and the Department of Pathology, The Charles T. Miller Hospital, St. Paul, Minnesota.

This study reveals three cases of corrected transposition (one with total situs inversus) where an accessory flap or umbrella-like formation of the venous atrioventricular valve presented into the outflow tract of the venous ventricle causing severe subpulmonary stenosis.

In one case the ventricular septum was intact, while in each of the other two, a ventricular septal defect lay below the obstruction. The latter combination effected a right-to-left shunt at ventricular level.

These cases are important because they portray anatomic details of a condition which, although uncommon, is potentially curable. Clinical identification of the subpulmonary stenosis appears best to be accomplished by selective angiocardiography at the level of the venous ventricle.