Ventriculo-venous communications in adults: ventriculographic observations in two female patients

Ventriculo-venous communications (VVC) were angiographically demonstrated in two adult female patients clinically presented with effort angina. During oxymetric studies there were minor to moderate left-to-right shunts. Concomitant, mild valvular aortic stenosis (AS) was present in one patient and hypertrophic obstructive cardiomyopathy (HOCM) in the other. It is believed that ventriculo-venous communications have contributed to the symptomatology in both patients. Symptoms were controlled medically in combination with dual (DDD) cardiac pacing with short AV-delay in one patient and only medically in the other patient. From the differential diagnostic point of view, superselective contrast injection into an 'inert' myocardial sinusoid or intramural contrast staining has been considered but could be excluded.