Supracristal Ventricular Septal Defect

Echo studies

Another case

A small portion of VSDs occur in the outflow portion of the right ventricle above the crista supraventricularis. These are known as doubly committed subarterial, conoseptal hypoplasia or supracristal VSDs. These defects are directly beneath the aortic valve on the left ventricular side of the septum and open below the pulmonary valve in the infundibulum on the right ventricular side. The defect is many times associated with aortic valve prolapse, which may lead to aortic valve insufficiency. These defects are found more commonly in people of Asian decent.

Ventricular septal defects, which are doubly committed subarterial and represent conoseptal hypoplasia, are usually well profiled from a parasternal long axis, short axis and subcostal view. In the subcostal and short axis view, the defect will be seen in the right ventricular outflow tract. It is important to thoroughly evaluate these patients for any evidence of aortic valve prolapse, specifically of the right coronary cusp, and for aortic regurgitation.