Abstract
A patient with tetralogy of Fallot developed a continuous flow-like murmur after radical operation. At right-heart catheterization with intracardiac phonocardio-graphy, the continuous murmur was recorded in the entire inflow tract of the right ventricle and was erroneously interpreted as being due to an arteriovenous fistula to the right ventricle. Thoracic aortography demonstrated aortic insufficiency and a residual ventricular septal defect with left-to-right shunt as the cause of the continuous murmur. The diagnostic value of intracardiac phonocardiography in such cases is based on the assumption that the diastolic component of aortic insufficiency is not recordable in the right ventricle; the reported case indicates that intracardiac phonocardiography may be of limited diagnostic value after radical operation for tetralogy of Fallot.
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