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      Acquired Obstruction of the Ventricular Septal Defect in Tetralogy of Fallot

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      Cardiology

      S. Karger AG

      Ventricular septal defect, Fallot’s tetralogy

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          Abstract

          The interventricular septal defect in patients with tetralogy of Fallot is, in most cases, a nonrestrictive malalignment type of defect. Rare examples of a restrictive defect have been described. We report a case of tetralogy of Fallot with pulmonic atresia in which the interventricular septal defect was found to be nonrestrictive at birth. The obstruction of the defect developed gradually, until, at the age of 6 years, a gradient of 55 mm Hg across the defect was found at repeat cardiac catheterization. Echocardiography proved that the acquired obstruction was due to excessive tricuspid valve tissue, while Doppler studies suggested a similar gradient between the right ventricle and the ascending aorta. This rare case should alert the clinician to the possibility of an acquired obstruction of the ventricular septal defect, with suprasystemic right ventricular pressure, in cases of tetralogy of Fallot, even if an early study suggested a nonobstructive defect. The diagnosis of this situation is of importance because of the poor prognosis which it carries.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1989
          1989
          12 November 2008
          : 76
          : 4
          : 309-311
          Affiliations
          Shaare Zedek Medical Center, Jerusalem, Israel
          Article
          174509 Cardiology 1989;76:309–311
          10.1159/000174509
          2805018
          © 1989 S. Karger AG, Basel

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          Page count
          Pages: 3
          Categories
          Original Paper

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