ANGIOCARDIOGRAPHIC DIAGNOSIS OF SUBPULMONIC VENTRICULAR SEPTAL DEFECT

1. Isolated septal defects of the ventricular septum below the aortic valve occur either in the membranous septum adjacent to the tricuspid valve or high in the outflow tract of the right ventricle beneath the pulmonic valve.2. On the left side of the heart, the subpulmonic defect is located in relation to the commissure between the right coronary and left coronary cusps. The membranous septal defect is located in relation to the commissure between the right coronary and noncoronary cusps.3. Differentiation of the two defects is important since the optimal surgical approach to each usually is different. This distinction can be accurately made by selective left ventricular angiocardiography.