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A Novel Case of Intramyocardial Ventricular Septal Defect With Surgical Implications
Katherine Rand1, Demetrios Mallios1,2, Pierre Wong1,2
1Children's Hospital Los Angeles, Los Angeles, California.
None:
An infant with an unrepaired ventricular septal defect (VSD) was found postmortem to have a unique VSD with anatomic features not previously described. Originally diagnosed as a perimembranous defect, autopsy revealed a tunnel-like channel with left ventricular origin inferior to the right coronary cusp, anterior to an intact membranous septum; an intramyocardial course posteroinferior to the pulmonary valve; and multiple right ventricular exit points superior to the anterior leaflet of the tricuspid valve. Accurate preoperative diagnosis is critical to guide surgical approach to this type of defect, which we term an intramyocardial VSD.
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