The Pathologic Anatomy of Ventricular Septal Defects

¹ The Congenital Heart Disease Research and Training Center, Hektoen Institute for Medical Research, and the Department of Pathology, Northwestern University Medical School.

1. The anatomic locations of the various types of ventricular septal defects are described, as related to the embryologic components of the ventricular septum, and the relationship of the defect to the aorta, pulmonary artery, and the crista supraventricularis.

2. The importance of the architecture of the muscle bundles of the right ventricle is reemphasized.

3. The isolated small ventricular septal defect is important pathologically because of its complications.

4. The isolated large ventricular septal defect, as seen at autopsy, produces right ventricular hypertrophy, and frequently but not always, left ventricular hypertrophy.

5. There are true anatomic Eisenmenger type complexes whose morphology differs from that of isolated ventricular septal defects.

6. The ventricular septal defect in tetralogy of Fallot, pulmonary stenosis with ventricular septal defect, and rarely tricuspid stenosis without transposition may dominate the physiologic picture.