Mechanism of acquired right ventricular outflow tract obstruction in patients with ventricular septal defect: An angiocardiographic study

Giacomo Pongiglione, Robert M. Freedom, David Cook, Richard D. Rowe

Research output: Contribution to journalArticlepeer-review

Abstract

Right ventricular outflow tract obstruction can complicate the natural history of patients with isolated ventricular septal defect. Although numerous pathologic mechanisms may be responsible for this phenomenon, it is less clear what the frequency is of each of these mechanisms in any cohort of patients studied in a single institution. We identified 20 patients with isolated ventricular septal defect from 1970 to 1981 who acquired a right ventricular outflow tract gradient of 25 mm Hg or more. They ranged in age at the initial catheterization investigation from 4 days to 23 months and at the subsequent study from 13 months to 8 years. Angiographically, 2 mechanisms were implicated in the 20 patients. Hypertrophy of right ventricular anomalous muscle bundles was identified in 19 of the 20 while hypertrophy of a malaligned infundibular septum (that is, classic tetralogy type) was identified in only 1 patient. These data indicate that acquired right ventricular outflow tract obstruction is rarely of the classic tetralogy type.

Original languageEnglish
Pages (from-to)776-780
Number of pages5
JournalThe American Journal of Cardiology
Volume50
Issue number4
DOIs
Publication statusPublished - 1982

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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