Abstract
Three patients with persistence of clinical venous-arterial admixture after successful valvotomy for severe pulmonary valvular stenosis with intact ventricular septum were studied by serial cardiac catheterization. Hemodynamic data after valvotomy documented the presence of atrial venous-arterial admixture in the absence of pulmonary hypertension, pulmonary stenosis or tricuspid stenosis in all 3 patients. Inadequate right ventricular distensibility was implicated as the cause of the atrial venous-arterial admixture. The secundum atrial septal defect was surgically closed to eliminate the potential hazards of such interatrial communications with significant venousarterial admixture. After closure, the inadequately compliant right ventricle accommodated itself to the reception of the total systemic venous return without residual evidence of right atrial hypertension.
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