TOF is the commonest of the cyanotic congenital cardiac conditions and consists of a perimembranous VSD (80%), subpulmonary
infundibular stenosis, overriding aorta and right ventricular hypertrophy (RVH).
Outflow obstruction might be observed due to relatively thick left ventricular wall in the subpulmonary
, the patient gave birth to one child without complications; however, her subpulmonary
stenosis was very mild (maximum gradient of 31 mmHg) and her pulmonary blood flow was well maintained (Qp/Qs = 0.9).
The location of the drain evidenced that all drains were in the pleural space, and, regarding the direction in the pleural space, 53% (53/100) of the drains were oriented towards the mediastinum, 41% (41/100) apical, and 6% (6/100) subpulmonary
. In two patients, kinking of the chest drain was found in the x-ray, with repositioning being required and, in 5% of the patients, subcutaneous emphysema was found, due to the last hole of the drain being inserted in the subcutaneous tissue, thus requiring repositioning.
The proximal cushions then fuse with the muscular crest of the right ventricle to form the septal component of the subpulmonary
(15.) Brawn W J et al., Early results for anatomic correction of transposition of the great arteries and for double-outlet right ventricle with subpulmonary
ventricular septal defect J Thorac Cardiovasc Surg 1988; 95: 230-238.
They will further form the basis for the muscular subpulmonary
infundibulum and will contribute to the membranous part of the IVS.
The inter-arterial and ventriculoarterial relationship develops after a complex set of events.6-8 In normal hearts, the great vessels are such that the pulmonary artery is superior, left and anterior due to the persistence and continued growth of subpulmonary
conus, and the aorta is posterior, inferior and right to the pulmonary artery1 due to the absorption of the subaortic conus.
And she has subpulmonary
stenosis, a narrowing of the pulmonary artery, which pumps blood to the lungs.
However, pulmonary valve gradient persisted after PBV in the echocardiography but any suspicious mass over the pulmonary valve or subpulmonary
muscle hypertrophy was reported.