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Case Reports in
Cardiology
From the earliest days of medicine to the present, case reports have been a critical
aspect of clinical education and knowledge development. In this comprehensive
volume, Dr.William C. Roberts, a renowned expert in the eld, explores the rich
history and ongoing importance of case reports in cardiology.
Through engaging and insightful analysis, the book demonstrates how case
reports have provided physicians with crucial insights into rare diseases, complex
conditions, and ground-breaking treatments. Drawing on a vast range of sources,
from seminal manuscripts to cutting-edge journals, it offers a unique perspective
on the role of case reports in medical education and practice of congenital heart
diseases and associated cardiac complications. It underscores how case reports
can be used to enhance diagnostic accuracy, identify new treatment options, and
promote innovation in the eld. In addition, the book provides valuable insights
into the process of writing and publishing case reports, including tips for young
physicians looking to break into the eld.
The book will be an indispensable guide to the history, practice, and ongoing
signicance of case reports for medical students, physicians, and researchers alike.
KEY FEATURES
◾
Provides a rich repository of diverse case reports in cardiology published by the
editor and his colleagues over 61years
◾
Features 52 clinical case studies related to Congenital Heart Disease, useful for
medical students and practicing cardiologists
◾
It is a valuable resource for young physicians seeking to establish a foothold in
medical research and academics
Case Reports in Cardiology Series
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Series Editor
William C. Roberts, MD
Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas
Case Reports in Cardiology: Congenital Heart Disease
Edited by Dr. William C. Roberts, MD
Case Reports in Cardiology: Valvular Heart Disease
Edited by Dr. William C. Roberts, MD
Case Reports in Cardiology: Coronary Heart Disease and Hyperlipidemia
Edited by Dr. William C. Roberts, MD
Case Reports in Cardiology: Cardiomyopathy
Edited by Dr. William C. Roberts, MD
Case Reports in Cardiology: Cardiac Neoplasm
Edited by Dr. William C. Roberts, MD
Case Reports in Cardiology: Cardiovascular Diseases with a Focus on Aorta
Edited by Dr. William C. Roberts, MD
For more information on this series, please visit https://www.routledge.com/CaseReports-in-Cardiology/book-series/CRIC
Case Reports in Cardiology
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Congenital Heart Disease
Edited by
William C. Roberts, MD
Designed cover image: Shutterstock
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First edition published 2024
by CRC Press
2385 NW Executive Center Drive, Suite 320, Boca Raton FL 33431
and by CRC Press
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
CRC Press is an imprint of Taylor& Francis Group, LLC
© 2024 selection and editorial matter, William C. Roberts; individual chapters, the contributors
This book contains information obtained from authentic and highly regarded sources. While
all reasonable efforts have been made to publish reliable data and information, neither the
author[s] nor the publisher can accept any legal responsibility or liability for any errors or
omissions that may be made. The publishers wish to make clear that any views or opinions
expressed in this book by individual editors, authors or contributors are personal to them and
do not necessarily reect the views/opinions of the publishers. The information or guidance
contained in this book is intended for use by medical, scientic or health-care professionals
and is provided strictly as a supplement to the medical or other professional’s own judgement,
their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the
appropriate best practice guidelines. Because of the rapid advances in medical science, any
information or advice on dosages, procedures or diagnoses should be independently veried.
The reader is strongly urged to consult the relevant national drug formulary and the drug
companies’ and device or material manufacturers’ printed instructions, and their websites,
before administering or utilizing any of the drugs, devices or materials mentioned in this
book. This book does not indicate whether a particular treatment is appropriate or suitable for
a particular individual. Ultimately it is the sole responsibility of the medical professional to
make his or her own professional judgements, so as to advise and treat patients appropriately.
The authors and publishers have also attempted to trace the copyright holders of all material
reproduced in this publication and apologize to copyright holders if permission to publish in
this form has not been obtained. If any copyright material has not been acknowledged please
write and let us know so we may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted,
reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other
means, now known or hereafter invented, including photocopying, microlming, and
recording, or in any information storage or retrieval system, without written permission from
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For permission to photocopy or use material electronically from this work, access www.
copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive,
Danvers, MA 01923, 978-750-8400. For works that are not available on CCC please contact
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Trademark notice: Product or corporate names may be trademarks or registered trademarks and
are used only for identication and explanation without intent to infringe.
ISBN: 978-1-032-52946-2 (hbk)
ISBN: 978-1-032-52945-5 (pbk)
ISBN: 978-1-003-40934-2 (ebk)
DOI: 10.1201/9781003409342
Typeset in Palatino LT Std
by Apex CoVantage, LLC
William Clifford Roberts, MD [1932–2023]
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A Remembrance
As a cardiac surgical associate at the NIH in Bethesda for 2 years, I attended my
father’s Monday conference regularly. There was a case of a healed traumatic aortic
rupture. The fellow discovered that the patient was in a motor vehicle accident
“several years before death.” To this fellow, WCR said, “Write this case up and have
it on my desk by Friday.” He added, “It takes about as long to write a brief report
as it does to write up the chart. Know the case precisely before going to the library
to search the literature.” He told the fellow to put the aorta in his pocket to remind
him what it looked like. “This is a single task, a single mission.” What to search for
in the library? “Are there any cases of healed traumatic aneurysm of the descending
thoracic aorta.” In 30 years, WCR had seen only 1 other, who died 7 days later, not
7 years. This was 1989, of course, before the ubiquitous use of CT scans.
The material for his case reports was this weekly conference in cardiovascular
pathology over 6 decades. During these conferences, WCR would personally
examine each surgical and autopsy cardiovascular specimen that was submitted—a
heart or valve or aorta—and a chart would be created for each patient. He would
typically examine each specimen as “an unknown.” To him it was a provocative
way to conduct the conference. He urged his students and residents and fellows to
“remember one thing about each case.” To him that was >600 “new things” a year.
He believed that studying the case at hand was better than general reading.
In a personal review of his own publications, William Clifford Roberts, MD
(WCR) listed 269 case reports out of a total of 1784 publications over a 60-year period,
1961–2022. This sheer number of case reports by one physician in cardiovascular
disease is perhaps a record in the eld.
As an editor in chief of 2 medical journals, he carefully considered the value of
case reports:
Usually, case reports have only 1 point, and information not pertinent to that
point is unnecessary. Indeed, unnecessary words and nonessential details
actually prevent clear focus on the patient. Thus, these “Brief Reports” must
be brief—no more than 2 or 3 double-spaced typed pages with few references.
Reports only 1 page long will be favored over those 3 pages long. Pertinent
illustrations may be the dominant element in conveying the message...Brief
Reports require clear thinking. Each word must count.
In nearly every case report of WCR, there is an illustration or photograph. WCR
preferred “drawings not words.” He would say, “There is nothing more important
than absolutely perfect photographs.” In his rst 20 years at NIH, he spent every
Tuesday and Thursday morning from 9am to noon with a photographer. He believed
the subject should occupy “85% of the frame.”
WCR graduated from Southern Methodist University (1954) and Emory
University School of Medicine (1958), then had 6 years of residency training. For
the next 60 years (1964–2023), he focused exclusively on cardiovascular pathology.
The rst 30 years were spent at NIH in Bethesda and the second 30 years at Baylor
University Medical Center in Dallas. He held his weekly conference past 90 years
of age.
My younger brother, John David Roberts, observed that WCR was “an intense
scholar, but also a loving person. He had both qualities. He was loved for the person,
not the accomplishments. One would never know he was a physician in daily
interactions. He was satised to be unknown. Though in the Public Health Service
for 30 years, he never wore the Navy uniform, even when it was recommended
at NIH. As a father he required respect, which included “Yes Sir” and “No Sir.”
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Manners were important to him, especially at the table for the evening meal, where
each of his children was asked to express what he or she learned that day.”
He will be remembered by his family not only for his contribution to the eld
of medicine, but for his hungry intellect, his indominable work ethic, his high
standards, and his loyalty to loved ones.
Charles Stewart Roberts, MD
October 1, 2023
Contents
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Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
About the Editor
Introduction
Case 1. Braunwald E, Ross RS, Morrow AG, Roberts WC. Differential
Diagnosis of Mitral Regurgitation in Childhood. Ann Intern Med.
1961;54(6):1223–1242
Case 3. Folse R, Roberts WC, Cornell WP. Increased Bronchial Collateral
Circulation in a Patient with Transposition of the Great Vessels
and Pulmonary Hypertension. Am J Cardiol. 1961;8(2):282–287
Case 12. Roberts WC. Anomalous Origin of Both Coronary Arteries from
the Pulmonary Artery. Am J Cardiol. 1962;10(4):595– 600
Case 15. Roberts WC, Mason DT, Braunwald E. Survival to Adulthood
in a Patient with Complete Transposition of the Great Vessels:
Including a Note on the Association of Endocrine Tumors with
Heart Disease. Ann Intern Med. 1962;57(5):834–842
Case 16. Roberts WC, Goldblatt A, Mason DT, Morrow AG. Combined
Congenital Pulmonic and Mitral Stenosis. N Engl J Med.
1962;267(25):1298–1299
Case 17. Roberts WC, Berry WB, Morrow AG. The Signicance of
Asplenia in the Recognition of Inoperable Congenital Heart
Disease. Circulation. 1962;26(6):1251–1253
Case 18. Roberts WC, Morrow AG, Mason DT, Braunwald E. Spontaneous
Closure of Ventricular Septal Defect, Anatomic Proof in an Adult
with Tricuspid Atresia. Circulation. 1963;27(1):90–94
Case 30. Roberts WC, Morrow AG. Aortico-Left Ventricular Tunnel.
ACause of Massive Aortic Regurgitation and of Intracardiac
Aneurysm. Am J Med. 1965;39(4):662–667
Case 51. Roberts WC, Eggleston JC, Humphries JO. Complex Congenital
Cardiac Malformation: Corrected Transposition, Origin of Both
Great Vessels from the Anatomic Right Ventricle, Common
Ventricle, and Dextroversion. Johns Hopkins Med J.
1967;120(3):155–161
Case 79. Perloff JK, Urschell CW, Roberts WC, Cauleld WH Jr.
Aneurysmal Dilatation of the Coronary Arteries in Cyanotic
Congenital Cardiac Disease. Report of a Forty Year Old Patient
with the Taussig-Bing Complex. Am J Med. 1968;45(5):802–810
Case 84. Glancy DL, Braunwald NS, O’Brien KP, Roberts WC. Scimitar
Syndrome Associated with Patent Ductus Arteriosus, Aortic
Coarctation and Irreversible Pulmonary Hypertension. Johns
Hopkins Med J. 1968;123(6):297–304
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
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*Note: Cases are numbered based on their number in WCR’s CV.
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Contents
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Case 92. Roberts WC. Anomalous Left Ventricular Band. An
Unemphasized Cause of a Precordial Musical Murmur. Am J
Cardiol. 1969;23(5):735–738
Case 93. Dean DC, Pamukcoglu T, Roberts WC. Rocks in the Right
Ventricle. AComplication of Congenital Right Ventricular
Infundibular Obstruction Associated with Chronic Pulmonary
Parenchymal Disease. Am J Cardiol. 1969;23(5):744–747
Case 94. Simon AL, Friedman WF, Roberts WC. The Angiographic
Features of a Case of Parachute Mitral Valve. Am Heart J.
1969;77(6):809–813
Case 108. Liddy TJ, Roberts WC. Chronic Intravascular Hemolysis (Renal
Hemosiderosis) After Incomplete Prosthetic Closure of a
Ventricular Septal Defect and Noncalcic Aortic Regurgitation.
Am J Clin Pathol. 1970;53(6):839–842
Case 122. Fortuin NJ, Roberts WC. Congenital Atresia of the Left Main
Coronary Artery. Am J Med. 1971;50(3):385–389
Case 138. Falcone MW, Perloff JK, Roberts WC. Aneurysm of the Nonpatent
Ductus Arteriosus. Am J Cardiol. 1972;29(3):422–426
Case 145. Falcone MW, Roberts WC. Atresia of the Right Atrial Ostium of
the Coronary Sinus Unassociated with Persistence of the Left
Superior Vena Cava: AClinicopathologic Study of Four Adult
Patients. Am Heart J. 1972;83(5):604– 611
Case 215. Fishbein MC, Obma R, Roberts WC. Unruptured Sinus of
Valsalva Aneurysm. Am J Cardiol. 1975;35(6):918–922
Case 327. Scott LP, Chandra RS, Roberts WC. Complex Congenital Heart
Disease: AMultiplicity of Therapeutic Options. Am Heart J.
1978;96(6):806–810
Case 332. Covarrubias EA, Sheikh MU, Isner JM, Gomes M, Hufnagel CA,
Roberts WC. Calcic Pulmonic Stenosis in Adulthood: Treatment
by Valve Replacement (Porcine Xenograft) with Postoperative
Hemodynamic Evaluation. Chest. 1979;75(3):399–402
Case 387. Cabin HS, Lester LA, Roberts WC. Congenital Heart Disease
with Trisomy 13: Use of the Echocardiogram in Delineating the
Location of a Left-to-Right Shunt. Am Heart J. 1980;100(4):563–566
Case 399. Arnett EN, Aisner SC, Lewis KB, Tecklenberg P, Brawley RK,
Roberts WC. Pulmonic Valve Stenosis, Atrial Septal Defect
and Left-to-Right Interatrial Shunting with Intact Ventricular
Septum. ADistinct Hemodynamic-Morphologic Syndrome.
Chest. 1980;78(5):759–762
Case 406. Waller BF, Sheikh MU, Roberts WC. Prolapsing Atrioventricular
Valve in Partial Atrioventricular Defect. Am Heart J. 1981;
101(1):108 –110
Case 435. Cabin HS, Wood TP, Smith JO, Roberts WC. Ebstein’s Anomaly in
the Elderly. Chest. 1981;80(2):212–214
Case 460. McManus BM, Luetzeler J, Roberts WC. Total Anomalous
Pulmonary Venous Connection: Survival for 62Years Without
Surgical Intervention. Am Heart J. 1982;103(2):298–301
Case 479. Waller BF, Smith FA, Kerwin DM, Roberts WC. Fetal Rubella
27Years Later. Chest. 1982;81(6):735–738
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............................................154
................................................ 176
......................................99
............ 104
............................. 116
................... 120
............... 127
..........................136
.............. 146
.............. 161
.....166
....................................... 171
............................180
............. 186
......................... 191
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Contents
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Case 482. Dicicco BS, McManus BM, Waller BF, Roberts WC. Separate
Aortic Ostium of the Left Anterior Descending and Left
Circumex Coronary Arteries From the Left Aortic Sinus of
Valsalva (Absent Left Main Coronary Artery). Am Heart J.
1982;104(1):153–154
Case 490. Roberts WC, Dicicco BS, Waller BF, etal. Origin of the Left Main
from the Right Coronary Artery or from the Right Aortic Sinus
with Intramyocardial Tunneling to the Left Side of the Heart via
the Ventricular Septum. The Case Against Clinical Signicance
of Myocardial Bridge or Coronary Tunnel. Am Heart J. 1982;104
(2 Pt 1):303–305
Case 508. Roberts WC, Spray TL, Shemin RJ, Maron BJ. Crisscrossed
Atrioventricular Valves and Prolonged Survival. Am J Cardiol.
1982;50(6):1436–1439
Case 534. Saftz JE, McIntosh CL, Roberts WC. Massive Right Ventricular
Outow Tract Aneurysm After Ventriculotomy for Subvalvular
Pulmonic Stenosis Associated with Peripheral Pulmonary
Arterial Stenoses. Am J Cardiol. 1983;51(8):1460–1462
Case 598. Warnes CA, Boger JE, Roberts WC. Eisenmenger Ventricular
Septal Defect with Prolonged Survival. Am J Cardiol. 1984;54(3):
460–462
Case 599. McManus BM, Hahn PF, Smith JA, Roberts WC, Jackson JH.
Eisenmenger Ductus Arteriosus with Prolonged Survival. Am J
Cardiol. 1984;54(3):462–464
Case 604. Warnes CA, Shugoll GI, Wallace RB, Roberts WC.
Atrioventricular Septal Defect (Primum Atrial Septal Defect)
with Prolonged Survival (Despite Severe Mitral Regurgitation
and Pulmonary Hypertension) and Associated Cardiac
Calcication (Mitral Anulus, Coronary Artery and Pulmonary
Tru nk). Am J Cardiol. 1984;54(6):689–691
Case 605. Ross EM, McIntosh CL, Roberts WC. “Massive” Calcication of a
Right Ventricular Outow Parietal Pericardial Patch in Tetralogy
of Fallot. Am J Cardiol. 1984;54(6):691–692
Case 616. Roberts WC, Robinowitz M. Anomalous Origin of the Left
Anterior Descending Coronary Artery from the Pulmonary
Trunk with Origin of the Right and Left Circumex Coronary
Arteries from the Aorta. Am J Cardiol. 1984;54(10):1381–1383
Case 617. Warnes CA, Maron BJ, Jones M, Roberts WC. Asymptomatic
Sinus of Valsalva Aneurysm Causing Right Ventricular
Outow Obstruction Before and After Rupture. Am J Cardiol.
1984;54(10):1383–1384
Case 635. Barbour DJ, Roberts WC. Origin of the Right from the Left
Main Coronary Artery (Single Coronary Ostium in Aorta). Am J
Cardiol. 1985;55(5):609
Case 642. Barth CW III, Dibdin JD, Roberts WC. Mitral Valve Cleft Without
Cardiac Septal Defect Causing Severe Mitral Regurgitation but
Allowing Long Survival. Am J Cardiol. 1985;55(9):1229–1231
Case 673. Barth CW III, Bray M, Roberts WC. Sudden Death in Infancy
Associated with Origin of Both Left Main and Right Coronary
..................................................... 213
........................................... 197
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..........................................204
............... 210
..................................... 218
.........................222
........................226
........ 229
.........................................234
......................................... 237
........239
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