‘Ring’ in the Left Ventricular Outflow Tract

Abstract

A 4-year-old boy (weight 17.1 kg, height 107 cm) presented with feeding difficulty, shortness of breath, and cyanosis. The preoperative transthoracic echocardiography examination showed a small perimembranous ventricular septal defect, severe right ventricular infundibular pulmonary stenosis with a peak gradient of 140 mmHg, right ventricular hypertrophy, right-to-left shunt, and good biventricular function. The pulmonary valve, main pulmonary artery, and branch pulmonary arteries were normal. The child was scheduled for right ventricular outflow tract infundibular resection and ventricular septal defect closure.