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Case rePorts in CarDioLogY
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Figure 3 Case #3. Heart. (a) Computed tomographic image showing the right
ventricular outow tract aneurysm (An) with calcium in its wall. (b) Opened right
ventricle showing the outow tract aneurysm. Adipose tissue nearly covers both
ventricles. (c) Outside of the heart anteriorly showing the portion of the right ven-
tricle that had been attached to the undersurface of the sternum. (d) Radiograph of
the explanted heart displaying the calcium present in the outow patch.
REFERENCES
1. Campbell M. Natural history of cyanotic malformations and comparison of all
common cardiac malformations. Br Heart J 1972;34:3–8.
2. Chiariello L, Meyer J, Wukasch DC, Hallman GL, Cooley DA. Intracardiac repair
of tetralogy of Fallot. Five-year review of 403 patients. J Thorac Cardiovasc Surg
1975;70:529–535.
3. Seybold-Epting W, Chiariello L, Hallman GL, Cooley DA. Aneurysm of pericardial right ventricular outow tract patches. Ann Thorac Surg 1977;24:237–240.
4. Kirklin JW, Bargeron LM, Pacico AD. The enlargement of small pulmonary
arteries by preliminary palliative operations. Circ 1977;56:612–617.
5. Arciniegas E, Farooki ZQ, Hakimi M, Perry BL, Green EW. Early and late results
of total correction of tetralogy of Fallot. J Thorac Cardiovasc Surg 1980;80:770–778.
6. Fuster V, McGoon DC, Kennedy MA, Ritter DG, Kirklin JW. Long-term evaluation (12 to 22years) of open heart surgery for tetralogy of Fallot. Am J Cardiol
1980;46:635–642.
302
Case 1766 huge right VentriCuLar outfLoW traCt aneurYsm
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7. Lane I, Treasure T, Leijala M, Shinebourne E, Lincoln C. Diminutive pulmonary
artery growth following right ventricular outow tract enlargement. Int J Cardiol
1983;3:175–185.
8. Ross EM, McIntosh CL, Roberts WC, Massive calcication of a right ventricular outow parietal pericardial patch in tetralogy of Fallot. Am J Cardiol
1984;54:691–692.
9. Payne WS, Kirklin JW. Late complications after plastic reconstruction of outow
tract in tetralogy of Fallot. Ann Surg 1961;154:53–57.
10.
Rosenthal A, Gross RE, Pasternac A. Aneurysms of right ventricular outow
patches. J Thorac Cardiovasc Surg 1972;63:735–740.
11.
Kaplan S, Helmsworth JA, McKinivan CE, Benzing G, Schwartz DC, Schreiber JT.
The fate of reconstruction of the right ventricular outow tract. J Thorac Cardiovasc
Surg 1973;66:361–374.
12.
Rieker R, Berman M, Stansel HC. Postoperative studies in patients with tetralogy
of Fallot. Ann Thorac Surg 1975;19:17–26.
13.
Kirklin JK, Kirklin JW, Blackstone EH, Milano A, Pacico AD. Effect of transan-
nular patching on outcome after repair of tetralogy of Fallot. Ann Thorac Surg
1989;48:783–791.
14.
Nollert G, Fischlein T, Bouterwek S, Böhmer C, Klinner W, Reichart B. Long-term
survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490
survivors of the rst year after surgical repair. JACC 1997;30:1374–1383.
15.
Knott-Craig CJ, Elkins RC, Lane MM, Holz J, McCue C, Ward KE. A26-year
experience with surgical management of tetralogy of Fallot: Risk analysis for
mortality or late reintervention. Ann Thorac Surg 1998;66:506–511.
16.
Nørgaard MA, Lauridsen P, Helvind M, Pettersson G. Twenty-to-thirty-seven-
year follow-up after repair for tetralogy of Fallot. Eur J Cardiothorac Surg
1999;16:125–130.
17.
Gatzoulis MA, Balaji S, Webber SA, Siu SC, Hokanson JS, Poile C, etal. Risk
factors for arrhythmia and sudden cardiac death late after repair of tetralogy of
Fallot: Amulticentre study. Lancet 20;356:975–981.
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Troost E, Meyns B, Daenen W, Van de Werf F, Gewillig M, Van Deyk K, etal.
Homograft survival after tetralogy of Fallot repair: Determinants of accelerated
homograft degeneration. Eur Heart J 2007;28:2503–2509.
19.
Munkhammar P, Carlsson M, Arheden H, Pesonen E. Restrictive right ventricu-
lar physiology after tetralogy of Fallot repair is associated with brosis of the
right ventricular outow tract visualized on cardiac magnetic resonance imaging. Eur Heart Jl—Cardio Imag 2013;14:978–985.
20.
Kotani Y, Chetan D, Ono N, Mertens LL, Caldarone CA, Van Arsdell GS, etal.
Late functional outcomes after repair of tetralogy of Fallot with atrioventricular septal defect: Adouble case-match control study. J Thorac Cardiovasc Surg
2013;145:1477–1484.
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Cuypers JA, Menting ME, Konings EE, Opic P, Utens EM, Helbing WA, et al.
Unnatural history of tetralogy of Fallot: Prospective follow-up of 40years after
surgical correction. Circ 2014;130:1944–1953.
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Galicia-Tornell M, Reyes-López A, Ruíz-González S, Bolio-Cerdán A, González-
Ojeda A, Fuentes-Orozco C. Treatment of Fallot tetralogy with a transannular
patch. Six years follow-up. Cir 2015;83:478–484.
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Dłuzniewska N, Podolec P, Skubera M, Smas-Suska M, Pajak J, Urbanczyk-
Zawadzka M, etal. Long-term follow-up in adults after tetralogy of Fallot repair.
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24. Simon BV, Subramanian S, Swartz MF, Wang H, Atallah-Yunes N, Aleris GM.
Serial follow-up of two surgical strategies for the repair of tetralogy of Fallot.
Semin Thorac Cardiovasc Surg 2019;31:515–523.
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de Castilhos GM, Ley ALG, Daudt NS, Horowitz ESK, Leiria TLL. Routine detec-
tion of atrial brillation/utter predicts a worse outcome in a cohort of tetralogy
of Fallot patients during 23years of follow-up. Pediatr Cardiol 2019;40:1009–1016.
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Padalino MA, Pradegan N, Azzolina D, Galletti L, Pace Napoleone C, Agati S,
etal. The role of primary surgical repair technique on late outcomes of tetralogy
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304
Index
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Note: Page numbers in italics indicate a gure and page numbers in bold indicate a table on
the corresponding page.
A
acute hemolysis, 119
adrenal cortical tumors, 44
adult ductal aneurysm, 131
anatomic lesions, in mitral regurgitation, 5
aneurysm
of ductus arteriosus, 130, 131
of pulmonary trunk unassociated with
intracardiac or great vessel left-to-right
shunting, 245
angiocardiogram, 52
aortic root, 83
congenital heart disease, 52
left ventricular, 114
parachute mitral valve, 113
right ventricle, 81, 82
angiography, in coronary arteries, 79
anomalous origin, of left anterior
descending coronary artery from
pulmonary trunk, 229
aortic coarctation, 91
aortico-left ventricular tunnel
anatomic features of, 65, 65
aneurysmal intracardiac portion of, 68
angiogram, 67
association of, 69
clinical examination, 62, 69
diagnosis, 62, 64
hemodynamic manifestations of, 69
pathologic aspects of, 64, 65
patient history, 62
physical ndings, 69
sinus of Valsalva, 66
thoracic aortogram, 63
ventricular septum traversed by, 68
aortic regurgitation, 62, 64
aortic root saturation, 85
aortic sinuses, 146
aortic valve, 69
arrhythmogenic right ventricular
cardiomyopathy (ARVC)
calcic deposits, 273
cardiac catheterization, 274
computed tomography, 274
diagnosis, 271, 272, 273, 274, 275
examination, 272, 273
hemodynamic data, 272
– 132
– 249, 246, 247 – 249
– 233
– 70
patient history, 271
repaired tetralogy of Fallot mimicking,
271
– 276
RV outow tract aneurysm, 273, 275
ventricular tachycardia, 274
ASD, see atrial septal defect (ASD)
atherosclerotic plaque, 215
atresia, of right atrial ostium, 136, 138,
atrial brillation, 1, 15, 72, 73, 239, 283, 283
atrial septal defect (ASD), 4, 7, 8, 14, 15,
atrioventricular septal defect, with
atrioventricular (A-V) valves, 71, 76
atrioventricular valves, crisscrossed
autologous parietal pericardium, 226
autopsy
– 144
139
clinical and hemodynamic
observations, 136
physiologic consequences of, 137
electrocardiogram, 120, 121
roentgenograms, 120, 121
– 175, 172 – 174, 223, 224
171
prolonged survival and associated
cardiac calcication, 222
calcic deposit, 225
diagnosis, 222, 224
patient history, 222
calcic deposits in stenotic pulmonic
valve, 207
electrocardiogram, 206
inadequate/excessive pulmonary blood
ow, 204
lateral angiogram, 204, 206
M-mode echocardiogram, 204, 206
posteroanterior radiograph, 204, 206
and prolonged survival, 204
transposition of aorta and pulmonary
trunk, 208, 209
vs. normal heart, 204, 205
aortico-left ventricular tunnel, 69
complex congenital cardiac
malformation, 74
in congenital atresia, 122
cyanotic congenital cardiac
disease, 79
renal hemosiderosis, 195
ventricular septal defect, 56, 116
– 225
– 209
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B
Blalock-Taussig anastomoses, 42, 157
bone marrow, erythroid elements in, 119
bronchial collateral circulation
in acyanotic patients, 20
diagnosis, 21, 21
dilated branchial arteries, 22, 24
dilated ostia of bronchial arteries, 22, 23
electrocardiogram, 21
examination, 21
great vessels, transposition of, 20
literature of augmentation of, 25
pathologic ndings, 22
patient report, 26
pulmonary hypertension, 20
selective right ventricular
angiocardiogram, 21, 22
ventricular septal defect, 22, 23
– 24
– 26
– 26
C
calcic deposits, 220, 225, 285, 285, 298
in mural thrombi, 104
in right ventricle, 104
cardiac apex, 73
cardiac calcic densities, see right ventricle
cardiac catheterization data, 47, 56, 192
cyanotic congenital cardiac disease,
80, 82
pulmonic valve stenosis, 163
scimitar syndrome, 91, 94
cardiac chambers, interior of, 58
cardiac ventricles, transverse sections of, 122
cardiovascular and pulmonary diseases
diagnosis, 171, 172
Ebstein’s anomaly, 180
examination, 172, 173, 174, 180
181
– 183
patient history, 171, 180
pulmonic-valve stenosis, 171
172
– 174
rubella infection, 191
Chiari’s network, in right atrium, 102
chordae tendineae, 13
chronic intravascular hemolysis, 116
clinical tests, 119
examination, 116, 117, 118
patient history, 116
cinearteriograms, 91
common ventricle, 77
complex congenital heart disease, 154
corrected transposition, 71, 77
dextroversion, 71
diagnosis, 72, 73
examination, 73, 74, 75
pathologic ndings, 71
– 181, 181 – 183, 184
– 181,
– 175,
– 195, 192 – 195
– 119
– 160
hemodynamic data, 156
patient report, 71, 73
congenital atresia, 120
diagnosis, 120, 121
examination, 122, 122
patient history, 120
congenital heart disease
angiocardiogram, 52
roentgenogram, 52
situs inversus in, 51, 54
splenic agenesis in, 51
with trisomy 13, 166, 167
congenital pulmonic and mitral stenosis,
47
congenital pulmonic stenosis (PS), 287
congenital right ventricular infundibular
congenital rubella syndrome, 191
congenital valvular pulmonic stenosis
coronary arteries, 71, 85
– 50
calcic deposits in pulmonic valve, 288,
289, 289, 291
complications of, 290
diagnosis, 287, 288, 288
examination, 289, 290
patient history, 287
pulmonic value regurgitation, 288
right bundle branch block, 288
sinus bradycardia, 288
ventricular septum, 290, 290
ventricular wall, focal scars in, 290,
290, 291
obstruction, complication of, 104
clinical ndings, 104
diagnosis, 104, 105
examination, 104, 106, 107
patient history, 104
abnormal right ventricular intramural
coronary arteries in, 268
diagnosis, 269, 270
patient history, 268
right ventricular infarction in, 268
sudden death in, 268
anatomy of, 122, 123
angiography, 79
anomalous origin of, 28
au t op s y, 28
clinical features, 30, 31
congenital anomalies of, 124
diagnosis, 80, 80, 81, 81, 83
dilatation and tortuosity of, 79, 83
embryology, 32
heart failure mechanism, 32
histology, 28
left anterior descending, 197, 198,
200, 201
left circumex, 197, 198, 200, 201
morphologic changes in, 83
– 74
– 126, 123
– 124, 124, 125
– 292
– 288
– 109
– 270
– 270
– 270
– 34
– 33
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origin of both right and left main (LM),
237
– 238, 238
pathologic features, 30, 32
patient history, 28, 79
right and left sections of, 87
sudden death in infancy, 242
surgical t herapy, 32
coronary ostial dimples, 264, 266
diagnosis, 264, 265
patient history, 264
coronary venous hypertension,
hemodynamic consequence of, 137
corrected transposition of great vessels,
71
Cushing’s syndrome, 44
cyanosis, 28
cyanotic congenital heart disease, 71
cytogenetic SNP microarray analysis, 293
– 77
cardiac catheterization data, 80, 82
clinical and hemodynamic
manifestations, 86
coronary arteries in, 79
hemoptysis, 89
morphologic features, 81, 84
patient report, 79
pulmonary hypertension, 87
– 80
– 244, 243
– 83
d
diastolic murmur, 1, 2
diffuse coronary atherosclerosis, 125
ductus arteriosus
aneurysmal dilatation, 127
aneurysm of, 130, 131
complications of, 133
diagnosis of, 128, 128, 132
examination, 128, 129
patient report, 127
persistent patency of, 127
treatment, 133
– 128
– 126
– 133
e
Ebstein’s anomaly, in elderly, 180 – 181,
181
ectasia, of coronary arteries, 83
Eisenmenger ductus arteriosus, with
– 183, 184
prolonged survival, 218
aortic and pulmonary arterial ends, 219
dilatation lesions, 218, 220
elastic brils in pulmonary trunk and
ascending aorta, 218, 219
hemodynamic data, 219
patient history, 218
plexiform lesion, 218, 220
pulmonary arteries with severe intimal
brous thickening, 218, 220
– 220
Eisenmenger’s complex, 26, 89
Eisenmenger ventricular septal defect, with
prolonged survival, 213
atherosclerotic plaque, 215
chest radiograph, 214
dilated and hypertrophied right and left
ventricles, 215
elastic brils, near identical conguration
of, 216
examination, 213, 215
heart and pulmonary arteries, 214
hemodynamic data, 213, 214
patient history, 213
pulmonary plexiform lesions, 216
electrocardiogram, 51
aortico-left ventricular tunnel, 64
atrial brillation, 120, 121
complex congenital cardiac
malformation, 72
parachute mitral valve, 111
P waves, 80, 81
right bundle branch block, 181
scimitar syndrome, 91, 92
total anomalous pulmonary venous
connection, 187
endocarditis, see bacterial endocarditis
extracorporeal circulation, 286
– 216
F
broelastosis, 6
G
great vessels
bronchial collateral circulation, 20
cardiac anomalies, 38
diagnosis, 37, 37, 38
examination, 42
malformations of, 51
pathologico-anatomic features of, 39, 42
patient history, 36
survival to adulthood in patient with,
36
– 45
transposition of, 51, 52
great vessel left-to-right shunting, 245
clinical ndings, 246
diagnosis, 247
patient history, 245
pulmonary hypertension, 245
– 43
– 249
– 26
– 249
H
Hackensellner’s theory, 32, 34
heart transplantation, 277, 280
hemodynamic-morphologic syndrome,
171
– 175, 172 – 174
307
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hemolysis, see specic types
Howell-Jolly bodies, 51
I
idiopathic hypertrophic subaortic stenosis, 115
indocyanine green dye dilution, 81
infantile ductal aneurysm, 130
infundibular stenosis, 234
intracardiac aneurysm, cause of, 62
intracardiac catheterization, 51
intracardiac debrillator, 277, 278
involution-persistence theor y, 32
– 70
L
left anterior descending coronary artery, 197,
198, 200, 201
anteroaortic intramyocardial course of,
251
– 253, 252, 252, 253
from pulmonary trunk, 229
left circumex coronary artery, 197, 198,
200, 201
retroaortic epicardial course, 251
252, 252, 253
left ventricular, angiocardiograms, 114
left ventricular band, anomalous
examination, 100, 101, 102
musical murmurs production, 100
patient history, 99
lungs
arteries in, 96
segments of, 92
Lutembacher’s syndrome, 7
– 233
– 253,
M
massive aortic regurgitation, cause of, see
aortico-left ventricular tunnel
mitral annulus, circumference of, 100
mitral regurgitation
anatomic lesions in, 5
chordae from mitral valve, 8
clinical evidence, 7
clinical ndings, 15
diagnosis, 2, 2, 3, 3, 7, 8, 8
examination, 239, 240, 240
mitral valve cleft without cardiac septal
defect, 239
patent ductus arteriosus, 283
patient history, 239
physical examination, 1, 2
mitral valve, 240
diastolic position of, 113
inspection of, 11
leaets, 13
severe deformity of, 113
– 241, 240
mitral valve anulus, calcic deposits in, 165
mitral valve cleft, without cardiac septal
defect causing severe mitral
regurgitation, 239
mitral valve prolapse, prolonged survival in
unoperated tetralogy of Fallot with,
257, 257
clinical and morphologic features of, 262
diagnosis, 257, 258
examination, 258, 259
patient history, 257
moderator bands, 102
myocardial bridge, clinical signicance of,
myocardial bers, 28, 30
myocardial ischemia, 237
– 261
200
– 201, 201, 202
– 241, 240
– 261
n
necropsy, 22
calcium, in cardiac ventricle, 104, 105
cardiac dysfunction, 180
ductus arteriosus, 128
brous cord, 99, 102
partial AV defect, 176
severe aortic regurgitation, 101
unruptured sinus of Valsalva, 147
nonpatent ductal aneurysm, see ductus
arteriosus
O
orthotopic heart transplantation, RVOT
aneurysm late following total repair
of tetralogy of Fallot, 296
299
ostium primum defect, 4, 14
ostium secundum defect, 7
– 300, 301 – 302
– 302, 297,
P
papillary muscle dysfunction, 99
parachute deformity, 110
parachute mitral valve
angiocardiography, 113
angiographic features of, 110
cardiac catheterization, 111
chordae tendineae of, 115
electrocardiogram, 111
examination, 112
hemodynamic data, 110, 111
patient history, 110
physical examination, 110
postmortem examination, 111
postoperative period, 111
surgical options, 111
partial atrioventricular defect, 239
– 113, 113, 114
– 115
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partial atrioventricular defect, prolapsing
atrioventricular valve in, 176, 177
patent ductus arteriosus, 89, 91
calcic deposits, 285
cardiac hemodynamic values in, 283
diagnosis, 283, 283
examination, 284
patient history, 282
peripheral pulmonary arterial
stenosis, 210
pheochromocytoma, 44
phonocardiogram, 177
porcine xenograft, for pulmonic valve
stenosis, 165
precordial musical murmur, unemphasized
cause of, 99
premature newborn, combined atresia of
one left-sided and one right-sided
cardiac valve in, 293
procainamide, cardiovascular and
pulmonary diseases, 180
pulmonary artery, 20
anomalous origin of coronary arteries
from, 28
pulmonary blood ow, 91
pulmonary hypertension, 20
pulmonary plexiform lesions, 216
pulmonary trunk, 88
aneurysmal dilatation of, 291
angina, 231, 233
anomalous origin, 229
cardiac ventricles, 230, 231
ligation, 233
observations, 232
precordial murmurs, 231
stenotic pulmonic valve, 269
unassociated with intracardiac or great
vessel left-to-right shunting, 245
246, 247
pulmonary vascular resistance, 89
pulmonic and mitral valve atresia,
combined, 293
pulmonic stenosis, 44
pulmonic valve balloon angioplasty, 289
pulmonic valve replacement, 291
pulmonic valve stenosis, 171
calcic deposits in, 161, 164, 165
cardiac catheterization data, 163
examination, 161
patient history, 161
porcine xenograft for, 165
pulmonic valvular stenosis, 112
– 283
– 102
– 22, 74
– 34
– 249
– 294, 294
– 162
– 92, 282 – 286
– 294, 294
– 26, 87, 245
– 233
– 175, 172 – 174
– 179
– 249,
R
renal hemosiderosis, see chronic
intravascular hemolysis
retroaortic epicardial course, of LC
coronary artery and anteroaortic
intramyocardial course of left LAD
coronary artery, 251
right coronary artery, 122
anomalous origin of, 242
examination, 243
patient history, 242
right main pulmonary artery, 249
right ventricle, 60, 104
angiocardiogram, 81, 82
calcic densities, 104
calcium in, 104
electrocardiogram, 104, 105
endocardium, 105
outow obstruction, 68, 68
wall and shines, 108
right ventricular infarction, in isolated
congenital valvular pulmonic
stenosis, 268
right ventricular origin of both great
vessels, 85
right ventricular outow tract aneurysm,
273, 275, 278, 279
hemodynamic data, 210, 210
infundibular obstruction, 211
patient history, 210
peripheral pulmonary arterial
stenosis, 211
postventriculotomy, 210
radiographs of chest, 211
surgical options, 210, 211
total repair of tetralogy of Fallot leading
to liver transplantation, 296
299
roentgenogram, 51, 52
rubella infection, 191
– 300, 301 – 302
aortico-left ventricular tunnel, 62
atrial brillation, 120, 121
cardiac calcic densities, 105
complex congenital cardiac
malformation, 73
in lung, 80, 80
scimitar syndrome, 91, 93
cardiac catheterization data, 192
clinical manifestations, 195
diagnosis, 191, 192
patient history, 192
– 253, 252, 252, 253
– 105, 106, 107
– 270
– 212
– 302, 297,
– 195, 192 – 195
S
scimitar syndrome, 91, 97
atrial septal defect in, 95
bidirectional shunting, 95
cardiac catheterization, 91, 94
component of, 95, 97
diagnosis, 91, 92, 93
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electrocardiogram, 91, 92
examination, 91
patent ductus, 95
patient history, 91
pulmonary and cardiac ndings, 92
roentgenogram, 91, 93
venous obstruction, 95
semilunar valves, 76
senile-type dilatation, 146
siderotic granules, 51
single coronary artery, 124, 126
sinus of Valsalva aneurysm, 234, 235
aneurysmal dilatation, 255
congenital aneurysms, 256
diagnosis, 234, 235, 255
fatal intrapericardial rupture of, 255,
255
– 256
infundibular stenosis, 234
origin of both right and left main
coronary arteries from, 237
patient history, 234, 255
right ventricular outow obstruction
before and after rupture, 234
unruptured, 146
151
– 152
with rupture, 63, 256
situs inversus, 51
subclavian-pulmonary arterial anastomosis,
60, 61
subvalvular aortic stenosis, 5
subvalvular pulmonic stenosis, 210
sudden death
and origin of left main and right
coronary arteries, 242
in isolated congenital valvular pulmonic
stenosis, 268
systolic murmur, 1, 7, 21, 39, 47
systolic pressures, 80, 85
– 95
– 236
– 147, 148, 149 – 150,
– 244, 243
– 270
T
Taussig-Bing complex, 86, 89
tendons, aberrant, 100
tetralogy of Fallot, 32, 36
arrhythmogenic right ventricular
cardiomyopathy, 271
with associated mitral valve prolapse,
257, 257
cardiac transplantation, 297
massive calcication of right ventricular
operative correction, 296
– 262, 258 – 261, 262
outow parietal pericardial patch in,
226, 227
– 276
patient history, 296
right ventricular outow tract aneurysm,
296
– 302, 299 – 300, 301 – 302
secondary arrhythmogenic right
ventricular cardiomyopathy, 277
278
thrombi, vascular, 39
tortuous coronary arteries, 81
total anomalous pulmonary venous
tricuspid atresia, 32
tricuspid regurgitation, 12
trisomy 13, congenital heart disease with,
– 279, 280 – 281
connection
diagnosis, 187
examination, 188
extensive calcic deposits, 190
illustrated in patient’s heart, 188
lack of excessive pulmonary vascular
resistance, 186
left-to-right shunt, 186
lungs, 189
patient history, 186
“Snowman” type, 186, 187
166, 167
– 297
– 281,
– 190
U
aneurysm of, 149 – 150
case report, 147
clinical features, 152
histologic sections, 147, 150
incidence of rupture, 151
necropsy, 147
pathogenesis, 147, 151
wall of, 150
– 152
V
ventricular hypertrophy, 4
ventricular myocardium, 270
ventricular septal defect, 4, 6, 7, 14, 15, 22, 85,
86, 116
bacterial endocarditis, 61
bronchial arterial collateral
circulation, 60
examination, 56, 59
pathologic ndings, 57
patient history, 56
patient survival of, 61
pertinent patho-anatomic features
of, 57
spontaneous closure of, 56, 61
ventricular tachycardia, 296, 298
– 57
310
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