THE ECHOCARDIOGRAPHIC ANATOMY OF VENTRICULAR SEPTAL-DEFECTS

Many of the controversies surrounding the description of ventricular s eptal defects arise from differences in the perspectives from which th ey are viewed. In this review, we analyse these defects as seen in cro ss-sectional echocardiographic images, correlating them with morpholog ic specimens. The classification we advocate, which now has a suitable pedigree, is a simple descriptive method distinguishing between perim embranous, muscular, and doubly committed types of defects. The approa ch is to categorise the defects as seen from the right ventricle, the usual port of access for surgeons. The term 'perimembranous' highlight s the proximity of the atrioventricular conduction axis to the margin of the defects in which the remnant of the membranous septum forms a d irect border. This system is applicable to all interventricular commun ications, no matter how malformed the heart may be in which they are e nclosed.