title: Membranous subpulmonic stenosis associated with ventricular septal defect and aortic insufficiency.
abstract: We present a case report of a patient with conal septal hypoplasia (supracristal) ventricular septal defect (VSD) complicated by aortic insufficiency (AI) and subpulmonic stenosis from a fibrous membrane. The development of AI with VSD is a well-recognized problem. However, the association of VSD, AI, and significant right ventricular outflow tract obstruction (RVOTO) is less common. Mechanisms of RVOTO include prolapse of an aortic valve cusp across the VSD, as well as infundibular hypertrophy or muscle bundles. Technical echocardiographic issues can make the diagnosis of VSD, AI, and RVOTO challenging. The presence of a discrete fibrous subpulmonary membrane is uncommon in this setting.
authors.affiliation: Divisions of Cardiothoracic Surgery and Cardiology, The Children's Hospital of Philadelphia, PA 19104-4399, USA.
authors.forename: G W
authors.initials: GW
authors.lastname: Raff
authors.forename: J W
authors.initials: JW
authors.lastname: Gaynor
authors.forename: P M
authors.initials: PM
authors.lastname: Weinberg
authors.forename: T L
authors.initials: TL
authors.lastname: Spray
authors.forename: M
authors.initials: M
authors.lastname: Gleason
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography