A Novel Approach for Transcatheter Management of Perimembranous Ventricular Septal Defect with a Subaortic Ridge

Figure 6

Exclusion criteria. (a) Echocardiographic parasternal long axis view with color flow mapping of a 10-year-old male patient demonstrated a moderately sized perimembranous subaortic VSD with septal aneurysm and subaortic ridge below the aneurysm and the VSD. (b) Cross-sectional echocardiogram in the long axis parasternal view with color flow mapping of an eight-year-old female patient demonstrating a moderately sized subaortic VSD abuting severely prolapsed RCC with significant subaortic stenosis (fibromuscular ridge) associated with a moderate-to-severe AR. (c) Cross-sectional echocardiogram in the long axis parasternal view of a 3.5-year-old male patient with two holes of perimembranous subaortic VSD (red arrow) with anterior deviation of the outlet septum into the right ventricle (yellow arrow) causing subaortic obstruction below the VSD. (d) Left ventricular angiogram in the left anterior oblique (70°) and cranial (30°) projection showing a moderate sized subaortic VSD (red arrow) with anterior deviation of the outlet septum into the right ventricle without compromising the right ventricular outflow tract (yellow arrow) producing an aortic override of 40% and subaortic obstruction below the VSD (narrow LVOT).

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