Ventricular Septal Defect with Aortic Insufficiency: A Clinical and Hemodynamic Study of 18 Proved Cases

Eighteen patients with the combination of ventricular septal defect and aortic insufficiency were studied. Nine also had infundibular pulmonary stenosis. Seventeen were treated by open-heart operations.The physical findings were those of a typical ventricular defect murmur and thrill together with an aortic insufficiency blow and a wide pulse pressure. A systolic murmur at the upper left sternal border with thrill is strongly suggestive of the additional lesion of infundibular pulmonary stenosis, but the presence or absence of infundibular pulmonary stenosis was indicated most accurately at cardiac catheterization and on inspection at operation. It was not of sufficient severity for signs of additional right ventricular hypertrophy to appear on the electrocardiogram.Retrograde aortography serves to demonstrate the severity of the aortic regurgitation.The problem of the surgical correction of these lesions will be the subject of a separate communication.