PMC4008348_01
Chest X-ray at admission: significant pulmonary congestion and reduced bilateral lung permeability due to pleural effusion were seen (cardiothoracic rate of 62%).
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fig1
Echocardiography: short axis (a) and apical 4-chamber (b) view. Perimembranous ventricular septal defect L   R flow and moderate tricuspid regurgitation flow were seen.
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fig2
Left to right shunt signal and perimembranous inlet type VSD were seen (high-velocity; maximum 3.9 m/s; pressure gradient of 60 mmHg) (Figure 2).
Perimembranous inlet-type VSD and membranous aneurysm ( ). The right-upper edge of the membranous aneurysm was tightly adhered and formed a mass with part of the tricuspid septal leaflet. The diameter of the VSD orifice was 8 mm while the original VSD size was speculated to be at least 15 x 20 mm.
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fig3
The diameter of the VSD orifice was 8 mm and the original VSD size was speculated to be at least 15 x 20 mm. (Figure 3).