Interventricular septal defect shown by left ventricular cine-angiocardiography.

This study was prompted by the need felt by our surgical colleagues for more accurate localization of the defect in the interventricujlar septum, as a high proportion of children undergoing operation for closure of these defects was noted to have large or multiple defects. Defects in the interventricular septum occur both in the membranous and muscular parts of the septum, and they may be single or multiple. At surgical closure the approach is dependent on the site of the defect. The approach may be from the right atrium through the tricuspid valve, through the right ventricular wall, through the apex of the left ventricle, or through the aorta and aortic valve (Gerbode et al., I958; Cooley, i959; Garamella et al., I960; Kay et al., I960; March et al., I96I; Mustard, I96I; Hudspeth et al., I962; Nicks et al., I962; Bjork, 1964, I965; Kay, Rodriguez, and Zimmerman, I965; Reynolds, I966; Gonzalez-Lavin and Barratt-Boyes, I969). Patients submitted for closure of an uncomplicated ventricular septal defect have a t shunt from the left ventricle through the defective septum and into the right ventricle. ?A septal defect with a shunt in this direction is commonly not shown directly by a right ventricular angiocardiogram. Later a shunt may be demonstrated when contrast medium recirculates through the heart. The site of the %defect in the septum is frequently not defined either early or late in the right ventricular %angiocardiogram. Since there is a shunt from the left ventricle across the defect, in patients in whom closure of the defect is contemplated advantage may