Ventricular septal defects : morphology of the doubly committed juxtaarterial and muscular variants

摘要

A previous review of the phenotypic features of ventricular septal defects,udconcentrated on the perimembranous variant, showing how its distinguishing feature,udas viewed from the right ventricle, was fibrous continuity in its postero-inferior rimudbetween the leaflets of the aortic and tricuspid valves. In this second review, theudfocus is on the morphology of those defects which have exclusively muscular rimsudwhen viewed from their right side, and the variant with the phenotypic feature ofudfibrous continuity between the leaflets of the two arterial valves. As with the defectsuddescribed as being perimembranous, once they have been characterised, it is theudposition of the defect relative to the components of the morphologically right ventricleudthat is the primary determinant of the options and strategies for treatment. Therefore,udclarification of the morphology is the key to establishing the related risks for eachudparticular defect.