Aneurysmlike Formations in Relation to Membranous Ventricular Septum

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Abstract
A left ventriculogram may show an aneurysmal protrusion toward the right ventricle in the subaortic area with or without an associated interventricular communication. The pathologic basis for such a finding is variable. It may well represent an aneurysm of the membranous ventricular septum which may be congenital or acquired. Either variety has the potential of rupturing into the right ventricle. The acquired aneurysms are usually mycotic. An aneurysm resulting from adhesion of the septal leaflet of the tricuspid valve to the rim of a membranous ventricular septal defect and causing complete or incomplete closure may also yield an aneurysmal formation. Pouches of the tricuspid valve resulting from excessive tissue, in association with a ventricular septal defect, can also be misinterpreted as an aneurysm of the membranous septum or as incomplete closure of a ventricular septal defect with aneurysm formation. In some cases, even at pathologic examination, the exact nature is difficult to identify. Separation of a true aneurysm of the membranous septum with adherent tricuspid valve from a spontaneously closed ventricular septal defect with aneurysmlike protrusion in the septal leaflet may not be possible.

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