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(Circulation. 1999;100:e12-e13.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Ventricular Septal Defect Patch Causing Right Ventricular Inflow Tract Obstruction

Shehzad Basaria, MD; Ali E. Denktas, MD; Mohammed Ghani, MD; Francis Thandroyen, MD

From the Division of Cardiology (A.E.D., M.G., F.T.) and the Department of Internal Medicine (S.B.), University of Texas Medical School, Houston.

Correspondence to Ali Emin Denktas, MD, Division of Cardiology, University of Texas, Houston, Medical School, 6431 Fannin St, MSB 1.246, Houston, TX 77030.

	Introduction

Top Introduction

 
A52-year-old black woman with history of ventricular septal defect (VSD) as a child presented with dyspnea on exertion, abdominal swelling, and bilateral lower extremity edema of 2 weeks' duration. Her physical examination revealed elevated jugular venous pressure, tricuspid stenosis murmur, and ascites.

Transthoracic echocardiograms (Figures 1 and 2) showed marked right atrial dilatation, severe tricuspid regurgitation, and a VSD patch causing right ventricular inflow tract obstruction. The area of turbulence is well above the tricuspid valve and is at the level of the patch bulging into the right ventricular inflow tract (Figure 2).

View larger version (50K): [in this window] [in a new window]   Figure 1.

View larger version (32K): [in this window] [in a new window]   Figure 2.

A transesophageal echocardiogram revealed the VSD patch bulging into the right ventricle, as seen in Figure 3.

View larger version (54K): [in this window] [in a new window]   Figure 3.

The patient was treated with diuretics and large-volume paracentesis and was referred for surgical intervention.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Basaria, S. Articles by Thandroyen, F. Search for Related Content PubMed PubMed Citation Articles by Basaria, S. Articles by Thandroyen, F. Related Collections Valvular heart disease Echocardiography Pediatric and congenital heart disease, including cardiovascular surgery