Abstract
The development of a septal aneurysm in the natural history of membranous ventricular septal defects usually makes the defect hemodynamically less significant. This report describes a case of severe right ventricular outflow obstruction produced by a membranous septal aneurysm in a patient who had an anterior malaligned ventricular septal defect with aortomitral discontinuity (double-outlet right ventricle). This patient did not have pulmonary stenosis other than the dynamic obstruction produced by the septal aneurysm. In this patient, the septal aneurysm produced both favorable and unfavorable hemodynamic effects. A reduction in the size of the ventricular septal defect produced a favorable effect, whereas a right ventricular outflow obstruction led to the unfavorable situation of right ventricular hypertension and hypertrophy. The large septal aneurysm in the presence of an already compromised right ventricular outflow tract related to an anteriorly malaligned septum resulted in severe obstruction.
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Ramaciotti C, Keren A, Silverman NH (1986) Importance of (perimembranous) ventricular septal aneurysm in the natural history of isolated perimembranous ventricular septal defect. Am J Cardiol 57(4):268–272
Reddy SC, Chopra PS, Rao PS (1997) Aneurysm of the membranous ventricular septum resulting in pulmonary outflow tract obstruction in congenitally corrected transposition of the great arteries. Am Heart J 133(1):112–119
Vidne BA, Chiariello L, Wagner H, Subramanian S (1976) Aneurysm of the membranous ventricular septum: surgical consideration and experience in 29 cases. J Thorac Cardiovasc Surg 71(3):402–409
Vidne BA, Subramanian S, Wagner HR (1976) Aneurysm of the membranous ventricular septum in transposition of the great arteries. Circulation 53(1):157–161
Wu MH, Chang CI, Wang JK, Lue HC (1994) Characterization of aneurysmal transformation in perimembranous ventricular septal defects: an adhered anterior leaflet of tricuspid valve predisposes to the development of left ventricular to right atrial shunt. Int J Cardiol 47(2):117–125
Wu MH, Wu JM, Chang CI et al (1993) Implication of aneurysmal transformation in isolated perimembranous ventricular septal defect. Am J Cardiol 72(7):596–601
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Bijulal, S., Sivasankaran, S., Sanjay, G. et al. Membranous Septal Aneurysm: An Unusual Cause for Right Ventricular Outflow Tract Obstruction in a Malaligned Ventricular Septal Defect with Aortomitral Discontinuity (Double-Outlet Right Ventricle) Associated with Visceral Heterotaxy. Pediatr Cardiol 30, 200–202 (2009). https://doi.org/10.1007/s00246-008-9299-8
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DOI: https://doi.org/10.1007/s00246-008-9299-8