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A five month old infant was referred to our centre for evaluation of a systolic murmur. A two dimensional (cross sectional) Doppler echocardiogram was undertaken which showed situs solitus, atrioventricular and ventriculoarterial concordance, an intact atrial septum, a normal aortic arch, and no duct. There were multiple muscular ventricular septal defects (VSDs) in the inlet profile and the pulmonary valve was mildly stenosed.
The midtrabecular VSD was small to moderate in size and had a large aneurysm on its right ventricular size (right) which was trying to restrict the left to right shunt.
Whereas aneurysms of the ventricular septum are frequently seen in relation to the perimembranous VSDs (leaflet tissue of the tricuspid valves tries to close them), an aneurysm of a mid-trabecula muscular VSD has not, up until now, been reported in the literature—truly a morphological novelty.