case_images: PMC4008348_01
case_images: Chest X-ray at admission: significant pulmonary congestion and reduced bilateral lung permeability due to pleural effusion were seen (cardiothoracic rate of 62%).
case_images: CRIM.CARDIOLOGY2012-429569.001.jpg
case_images: PMC4008348_01_CRIM.CARDIOLOGY2012-429569.001.jpg
case_images: fig1
case_images: Echocardiography: short axis (a) and apical 4-chamber (b) view. Perimembranous ventricular septal defect L   R flow and moderate tricuspid regurgitation flow were seen.
case_images: CRIM.CARDIOLOGY2012-429569.002.jpg
case_images: PMC4008348_01_CRIM.CARDIOLOGY2012-429569.002.jpg
case_images: fig2
case_images: 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).
case_images: 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.
case_images: CRIM.CARDIOLOGY2012-429569.003.jpg
case_images: PMC4008348_01_CRIM.CARDIOLOGY2012-429569.003.jpg
case_images: fig3
case_images: 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).