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Chapter 13 Ventricular Septal Defects

Video 13.1 Parasternal short-axis view of a central perimembraneous ventricular septal defect

Parasternal short-axis clip in color compare mode demonstrating a central perimembraneous VSD just under the septal leaflet of the tricuspid valve (between 10 and 11 o'clock) with valve tissue restricting the degree of shunting.

Video 13.2 Subxiphoid right anterior oblique view of double-chambered right ventricle

Subxiphoid right anterior oblique view in color compare mode demonstrating a right ventricle (RV) muscle bundle under the pulmonary valve producing turbulent flow and forming double-chambered RV in association with a central perimembraneous VSD. The color Doppler VSD jet is directed into the RV chamber proximal to the RV muscle bundle.

Video 13.3a Large inlet ventricular septal defect

Subxiphoid left anterior oblique 2D view demonstrating a large inlet defect in the posterior septum at the level of the atrioventricular valves with normal-appearing tricuspid and mitral valves.

Video 13.3b Large inlet ventricular septal defect

Parasternal short-axis 2D sweep demonstrating a large inlet defect in the posterior septum at the level of the atrioventricular valves with normal-appearing tricuspid and mitral valves.

Video 13.4 Subxiphoid left anterior oblique view of an outlet ventricular septal defect (VSD)

Subxiphoid left anterior oblique clip demonstrating an outlet VSD just under the pulmonary valve and aortic valve with complete absence of the conal septum.

Video 13.5 Parasternal short-axis view of an outlet ventricular septal defect (VSD)

Parasternal short-axis clip demonstrating an outlet VSD located between 12 and 2 o'clock. Note that the membranous septum between 10 and 11 o'clock is intact.

Video 13.6 Long-axis color Doppler view in transesophageal echocardiography (TEE) of an outlet ventricular septal defect (VSD)

TEE in long-axis color Doppler view demonstrating an outlet VSD with the right coronary cusp of the aortic valve prolapsed through the defect restricting flow.

Video 13.7 Subxiphoid right anterior oblique view of an anterior malalignment ventricular septal defect (tetralogy of Fallot)

Subxiphoid right anterior oblique clip demonstrating an anterior malalignment ventricular septal defect with hypoplasia of the conal septum in tetralogy of Fallot.

Video 13.8 Parasternal short-axis view of a mild anterior malalignment ventricular septal defect (tetralogy of Fallot)

Parasternal short-axis view at the base of the heart demonstrating tetralogy of Fallot. The conal septum is positioned out of line with the aorta, more anteriorly and impinging on the right ventricular outflow tract.

Video 13.9 Subxiphoid left anterior oblique view in color compare mode of a large posterior malalignment ventricular septal defect (VSD)

Subxiphoid left anterior oblique sweep in color compare mode demonstrating a large VSD with posterior malalignment of the conal septum with potential for subaortic obstruction and associated aortic valve hypoplasia.

Video 13.10 Parasternal long-axis clip in color compare mode showing multiple muscular ventricular septal defects (VSDs)

Parasternal long-axis clip in color compare mode demonstrating multiple muscular VSDs with left-to-right shunt by color Doppler.

Video 13.11 Three-dimensional transesophageal echocardiography (TEE) clip demonstrating prolapse of the right aortic valve cusp into an outlet ventricular septal defect (VSD)

3D TEE clip demonstrating prolapse of the right aortic valve cusp into an outlet VSD from (a) the right ventricle side and (b) the left ventricle side.

Video 13.12 Parasternal short-axis view of an anterior muscular ventricular septal defect (VSD)

Parasternal short-axis clip demonstrating a moderate anterior muscular VSD with a predominantly right-to-left color Doppler shunt and a flattened ventricular septum in systole, indicating markedly elevated right ventricular pressure in a patient with Eisenmenger syndrome.

Video 13.13 Transgastric transesophageal echocardiography (TEE) clip demonstrating a residual intramural ventricular septal defect (VSD)

Transgastic TEE in gastric view (color compare mode) showing a residual intramural VSD after repair of tetralogy of Fallot. Note the more horizontal positioning of the VSD patch and the attachment of the superior portion of the patch to the RV trabeculations.

Video 13.14 Long-axis transesophageal echocardiography (TEE) clip in color compare mode after repair of tetralogy of Fallot

Long-axis TEE clip at 120° in color compare mode demonstrating a residual VSD just below the aortic valve after repair of tetralogy of Fallot.

Video 13.15a Long-axis 3D transesophageal echocardiography (TEE) clips after successful device closure of a ventricular septal defect (VSD)

3D TEE clips in the long-axis view (around 120°) after successful device closure of a central perimembranous defect shrouded in tricuspid valve tissue. Note the VSD device on the right ventricle side, which is positioned in the tricuspid valve tissue windsock.

Video 13.15b Long-axis 3D transesophageal echocardiography (TEE) clips after successful device closure of a ventricular septal defect (VSD)

3D TEE clips in the long-axis view (around 120°) after successful device closure of a central perimembranous defect shrouded in tricuspid valve tissue. The VSD device on the left ventricle side is positioned just below the aortic valve.