A rare case of subarterial ventricular septum defect associated with other cardiac pathologies in an adult.

Abstract

A 67-year-old woman developed exertional dyspnea. Echocardiography revealed a subarterial ventricular septum defect (VSD), hypertrophy of the basal septum leading to subvalvular obstruction, severe aortic regurgitation, and an ascending aorta aneurysm (Fig. 1, Videos 1 and 2). Surgical repair consisted of transaortic VSD patch closure, septal myectomy, and separate replacement of the aortic valve and the ascending aorta (Fig. 2). Figure 1 Transesophageal echocardiogram (TEE). Two-dimensional TEE without (A) and with color (B) showing subarterial VSD (red arrow) and hypertrophy of the basal septum (white arrow) below the VSD. The defect was ∼5 mm in size and hemodynamically ... Figure 2 (A) At the time of operation, the VSD (white arrow) was larger (12×15 mm) than anticipated and was limited upstream by the semilunar valves, but was otherwise surrounded by muscle. The tricuspid aortic valve was excised due to severe calcification ... Video 1 Transesophageal echocardiogram (TEE). Two-dimensional TEE without color, showing subarterial VSD and hypertrophy of the basal septum below the VSD. Download Video 1 via http://dx.doi.org/10.1530/ERP-14-0022-v1. Download Video 1 Video 2 Transesophageal echocardiogram (TEE). Two-dimensional TEE with color, showing subarterial VSD and hypertrophy of the basal septum below the VSD. Download Video 2 via http://dx.doi.org/10.1530/ERP-14-0022-v2. Download Video 2