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| {{Infobox_Disease |
| | #Redirect[[Congenital heart disease]] |
| Name = {{PAGENAME}} |
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| Image = Congenital heart defect 0003.jpg|
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| Caption = Subvalvular Ventricular Septal Defect: Gross, good view of defect with overriding aorta. <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
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| }}
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| {{SI}}
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| {{CMG}}
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| '''Associate Editor-in-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
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| ==Overview==
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| ==Major categories==
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| ===Patent ductus arteriosus===
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| {{main|Patent ductus arteriosus}}
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| The [[ductus arteriosus]] is a temporary pathway in the [[fetus|foetal]] heart between the [[pulmonary artery]] and [[aorta]], which allows blood to bypass the fetus's nonfunctioning lungs until birth. Normally, the ductus closes within a few hours or days of birth; when it does not, the result is patent ductus arteriosus. This defect is common in [[premature birth|premature]] infants but rare in full-term infants.
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| ===Hypoplasia===
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| {{main|Hypoplastic left heart syndrome}}
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| [[Hypoplasia]] can affect the heart, which typically results in the failure of either the [[right ventricle]] or the [[left ventricle]] to develop adequately, leaving only one side of the heart capable of pumping blood to the body and [[lung]]s. Hypoplasia of the heart is rare but is the most serious form of CHD; it is called [[hypoplastic left heart syndrome]] when it affects the left side of the heart and [[hypoplastic right heart syndrome]] when it affects the right side of the heart. In both conditions, the presence of a [[patent ductus arteriosus]] (and, when hypoplasia affects the right side of the heart, a [[patent foramen ovale]]) is vital to the infant's ability to survive until emergency heart surgery can be performed, since without these pathways blood cannot circulate to the body (or lungs, depending on which side of the heart is defective). Hypoplasia of the heart is generally a [[cyanotic heart defect]].
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| ===Obstruction defects===
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| Obstruction defects occur when heart valves, arteries, or veins are [[stenosis|abnormally narrow]] or [[atresia|blocked]]. Common obstruction defects include [[pulmonary valve stenosis]], [[aortic valve stenosis]], and [[aortic coarctation|coarctation of the aorta]], with other types such as [[bicuspid aortic valve stenosis]] and [[subaortic stenosis]] being comparatively rare. Any narrowing or blockage can cause heart enlargement or [[hypertension]].
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| ===Septal defects===
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| The septum is a wall of tissue which separates the [[left heart]] from the [[right heart]]. It is comparatively common for defects to exist in the [[interatrial septum]] or the [[interventricular septum]], allowing blood to flow from the left side of the heart to the right, reducing the heart's efficiency. [[Ventricular septal defect]]s are collectively the most common type of CHD, although approximately 30% of adults have a type of [[atrial septal defect]] called [[patent foramen ovale]]. Septal defects may or may not cause [[cyanosis]] depending on the severity of the defect.
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| ===Cyanotic defects===
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| [[Cyanotic heart defect]]s are called such because they result in [[cyanosis]], a bluish-grey discoloration of the skin due to a lack of [[oxygen]] in the body. Such defects include [[persistent truncus arteriosus]], [[total anomalous pulmonary venous connection]], [[tetralogy of Fallot]], [[transposition of the great vessels]], and [[tricuspid atresia]].
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| ==Signs and Symptoms==
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| Symptoms and signs are related to the type and severity of the heart defect. Some children have no signs while others may exhibit shortness of breath, cyanosis, chest pain, syncope, sweating, [[heart murmur]], respiratory infections, underdeveloping of limbs and muscles, poor feeding, or poor growth. Most defects cause a whispering sound, or murmur, as blood moves through the heart causing some of these symptoms. All of these symptoms occur at a young age of a child or infant and are typically found during a physical examination.
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| ==Treatment==
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| Sometimes CHD improves with no treatment necessary. At other times the defect is so small and does not require any treatment. Most of the time CHD is serious and requires surgery and/or medications. Medications include diuretics, which aid the baby in eliminating water, salts, and digoxin and in strengthening the contraction of the heart. This slows the heartbeat and removes some fluid from tissues. Some defects require surgical procedures to repair as much as possible to restore circulation back to normal. In some cases, multiple surgeries are needed to be performed to help balance the circulation. Interventional cardiology now offers patients minimally invasive alternatives to surgery. Device closures can now be treated with a standard transcatheter procedure using a closure device mounted on a balloon catheter.
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| ==Pathological Findings==
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| [http://www.peir.net Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0002.jpg|Interventricular Septal Defect (Muscular Septum): Gross, natural color, muscular septal defect in newborn
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| Image:Congenital heart defect 0005.jpg|Atrioventricular Canal: Gross, right ventricular view of canal defect
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| Image:Congenital heart defect 0006.jpg|Atrioventricular Canal: Gross, left ventricle view of canal defect (very good example)
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| Image:Congenital heart defect 0007.jpg|Perimembranous Ventricular Septal Defect: Gross, an excellent example
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| Image:Congenital heart defect 0008.jpg|Ventricular Septal Defect: Gross, subvalvular defect, left ventricle view of tetralogy of Fallot (very good example)
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| Image:Congenital heart defect 0010.jpg|Subpulmonic Ventricular Septal Defect: Gross, a well shown lesion.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0013.jpg|Ventricular Septal Defect: Gross, natural color, view of opened heart with lungs attached shows rather well a subvalvular VSD
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| Image:Congenital heart defect 0014.jpg|Atrioventricular Canal: Gross, patch repair of defect seen from left side showing left atrial portion extending into a cleft mitral valve
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| Image:Congenital heart defect 0015.jpg|Atrioventricular Canal: Gross, corrected defect with patch viewed from left side atrium and cleft mitral valve
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0016.jpg|Atrial Septal Defect: Gross, (an excellent example) foramen ovale defect with right ventricular hypertrophy and fatty infiltration of the right ventricular wall, enlarged right atrium
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| Image:Congenital heart defect 0017.jpg|Ventricular Septal Defect: Gross close-up adult heart, small perimembranous septal defect (very good example)
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| Image:Congenital heart defect 0018.jpg|Interventricular Septal Defect (Muscular Septum): Gross, natural color, low septal defect shown from aortic outlet. The same defect (with a probe in hole) shown from right ventricle.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0019.jpg|Interventricular Septal Defect (Muscular Septum): Gross natural color right ventricular outlet (probe in defect) view from left ventricular side
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| Image:Congenital heart defect 0020.jpg|Atrial Septal Defect: Gross natural color infant heart foramen ovale defect, septum secundum
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| Image:Congenital heart defect 0021.jpg|Aortic Subvalvular Ventricular Septal Defect: Gross, natural color, septal defect has patch repair. Aortic valve is myxomatous. A complex case of truncus with interrupted arch.
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0022.jpg|Interventricular Septal Defect Membranous Septum: Gross natural color close-up (an excellent demonstration)
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| Image:Congenital heart defect 0023.jpg|Interventricular Septal Defect Membranous Septum: Gross natural color small defect well shown. Aortic cusps are scarred and one is perforated
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| Image:Congenital heart defect 0024.jpg|Subvalvular Ventricular Septal Defect: Gross, natural color, close-up view of aortic outflow tract with a large subvalvular defect
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0025.jpg|Membranous Interventricular Septal Defect: Gross natural color subvalvular defect with probe immediately inferior to membranous septum
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| Image:Congenital heart defect 0026.jpg|Subvalvular Ventricular Septal Defect: Gross, fixed tissue, large subpulmonic defect apparently represent left displacement of the pulmonary artery
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| Image:Congenital heart defect 0027.jpg|Interventricular Septal Defect: Gross, fixed tissue, opened right ventricular outflow tract positioned to show perimembranous septal defect (as surgeon would see it during repair)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0028.jpg|Ventricular Septal Defect Muscular: Gross, natural color, view from right ventricle with probe in defect right ventricular hypertrophy is evident
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| Image:Congenital heart defect 0029.jpg|Ventricular Septal Defect Muscular: Gross, natural color, view from left ventricle with probe in defect
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| Image:Congenital heart defect 0030.jpg|Interventricular Septal Defect Subvalvular with Patch Repair: Gross natural color 19yo with Tetralogy of Fallot also shows overriding aorta
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0031.jpg|Interventricular Septal Defect Subvalvular with Patch Repair: Gross, natural color, close-up
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| Image:Congenital heart defect 0032.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, natural color, view from right ventricle. A case of inverted ventricles
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| Image:Congenital heart defect 0033.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, natural color, view from left ventricular outflow tract
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0034.jpg|Ventricular Septal Defect (Subvalvular): Gross, fixed tissue, small heart with opened aorta and subvalvular defect shown. A case of pulmonary artery atresia
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| Image:Congenital heart defect 0035.jpg|Truncus Arteriosus with Subvalvular Ventricular Septal Defect: Gross, natural color, an excellent view of subvalvular defect. Quadricuspid truncus valve and type I origin of pulmonary arteries
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0038.jpg|Av Canal with Left Side Bjork Shiley Prosthetic Valve: Gross, natural color, a close-up view of valve and the bridging defect
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| Image:Congenital heart defect 0039.jpg|Interventricular Septal Defect (Perimembranous) with Patch Repair: Gross, fixed tissue, a close-up view of patch repair from right ventricle
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0040.jpg|Conduit Right Ventricle to Pulmonary Artery: Gross, fixed tissue, opened conduit showing sutures into ventricle and patch closed perimembranous interventricular septal defect
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| Image:Congenital heart defect 0041.jpg|Ventricular Septal Defect (Perimembranous): Gross, natural color, (quite good photo - lesion before the operation)
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| Image:Congenital heart defect 0042.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Tetralogy of Fallot; Gross, fixed tissue, close-up view of a large subvalvular defect repaired with a Dacron patch (overgrown with fibrous tissue prominent subaortic shelf with endocardial thickening).
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0043.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Tetralogy of Fallot; Gross, fixed tissue, close-up view of a large subvalvular defect repaired with a Dacron patch
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| Image:Congenital heart defect 0044.jpg|Ventricular Septal Defect (Subvalvular) Repaired: Gross, fixed tissue, close-up view of Dacron patch. Nearly completely covered with fibrous tissue
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| Image:Congenital heart defect 0045.jpg|Transposition Great Vessels with Interventricular Septal Defect: Gross, fixed tissue, opened left ventricular outflow tract into a pulmonary artery (perimembranous defect)
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0046.jpg|Transposition Great Vessels with Interventricular Septal Defect: Gross, fixed tissue, close-up of interventricular septal defect and pulmonary valve
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| Image:Congenital heart defect 0047.jpg|Double Outlet Right Ventricle: Gross, fixed tissue, close-up view of left ventricular outflow tract and patched ventricular septal defect. The override is obvious in this (very good) close-up view
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| Image:Congenital heart defect 0048.jpg|Perimembranous Ventricular Septal Defect: Gross, fixed tissue, opened left ventricular outflow tract into aorta. Defect was patched 3 days prior to death
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0049.jpg|Perimembranous Ventricular Septal Defect: Gross, fixed tissue, lesion seen from right ventricle (with patch)
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| Image:Congenital heart defect 0050.jpg|Perimembranous Interventricular Septal Defect: Gross, fixed tissue, view from right atrium and ventricle with patch placed three days prior to death.
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| Image:Congenital heart defect 0051.jpg|Ventricular septal defect
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Congenital heart defect 0052.jpg|Ventricular septal defect, view from left ventricle
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| Image:Congenital heart defect 0053.jpg|Atrial Septal Defect, Septum Primum; View from Right Atrium (a 4 month old baby)
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| Image:Congenital heart defect 0054.jpg|Atrial Septal Defect, Septum Primum; Also Cleft in Anterior Cusp of Mitral Valve
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:Hypoplastic left ventricle 1.jpg|Hypoplastic left ventricle
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| </gallery>
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| </div>
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| <div align="left">
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| <gallery heights="175" widths="175">
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| Image:3240.jpg|Right Ventricle Hypoplasia: Gross natural color good example showing tiny tricuspid inlet and very small but quite thick right ventricle
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| Image:3241.jpg|Right Ventricle Hypoplasia: Gross natural color view from right atrium showing patent foramen ovale and very small tricuspid valve
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| Image:3242.jpg|Right Ventricle Hypoplasia: Gross natural color external view of heart showing very large left ventricle and very small right ventricle delineated by anterior descending branch of left coronary artery
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| </gallery>
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| </div>
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| ==References==
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| {{Reflist|2}}
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| ==See Also==
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| * [[Congenital heart disease]]
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| ==External Links==
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| *[http://www.itsmyheart.org/ It's My Heart, Inc. - A National Non-Profit Organization who supports and advocates for those affected by Congenital Heart Defects]
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| *{{DMOZ|Health/Conditions_and_Diseases/Cardiovascular_Disorders/Heart_Disease/Congenital/}}
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| * [http://www.congenitalheartdefects.com/ General information about congenital heart defects]
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| *[http://www.dhg.org.uk Down's Heart Group. A charity offering support and information relating to heart conditions associated with Down's Syndrome.]
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| {{Congenital malformations and deformations of circulatory system}}
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| [[Category:Congenital heart disease]]
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| [[Category:Cardiology]]
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| [[de:Herzfehler]]
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| [[fr:Cardiopathie congénitale]]
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| [[nn:Medfødd hjartefeil]]
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| [[pl:Wada serca]]
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| [[sr:Урођене срчане мане]]
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| {{WH}}
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| {{WS}}
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