CONGENITAL AORTIC SEPTAL DEFECT

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Abstract
The authors report an instance of proved congenital aortic septal defect, re-view the pertinent data on 10 previously reported cases and discuss the diagnosis of this lesion. The findings in the presented case and a review of findings in previously reported cases indicate that the avg. age of death is 14 yrs.; cardiac insufficiency dates from early infancy; the basic murmurs are those of a free leak from the aorta above the cusps; the heart is always much enlarged; other congenital cardiovascular lesions are usually absent; the pulmonary arterial tree is dilated. This defect must be differentiated from (1) patent ductus arteriosus, which is usually but not always possible. In the latter anomaly the heart and pulmonary vessels are not so strikingly enlarged and the murmur is not as superficial in character. (2) Atrial septal defect should be distinguishable because it does not produce excessive aortic pulsations nor an increased pulse pressure and gives characteristic findings on right heart catheterization. (3) In atrial septal defect combined with a patent ductus arteriosus, right heart catheterization will also be conclusive. (4) In truncus communis which produces cyanosis early, a systolic murmur and thrill are usually present. The main pulmonary artery and branches are rudimentary or absent.