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Fig. 2 | Orphanet Journal of Rare Diseases

Fig. 2

From: Assessing the criteria for definition of perimembranous ventricular septal defects in light of the search for consensus

Fig. 2

The images show the features of the defects shown in Fig. 1 as viewed from the left ventricle. In each heart, there is a fibrous postero-inferior border. This proved to be the defining feature of the perimembranous defect. In these hearts, the fibrous border is formed of continuity between the leaflets of the aortic, mitral, and tricuspid valves, incorporating also the atrioventricular component of the membranous septum. In the central defect, shown in the left hand panel, there is also a remnant of the interventricular component of the membranous septum, forming the so-called membranous flap. In the central and inlet defects (left hand and central panels), the fibrous continuity involves the septal leaflet of the tricuspud valve, whereas in the outlet defect (right hand panel), there is also continuity with the antero-superior leaflet of the valve in the roof of the defect. The postero-inferior border, nonetheless, is still formed by continuity between the septal leaflet of the tricuspid valve and the mitral valve via the substance of the atrioventricular component of the membranous septum

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