FIG 32.35 Different types of perimembranous defects seen in the longaxis oblique views (A) Defect opening to the inlet of the right ventricle (arrows delineate the septal leaflet of the tricuspid valve) (B) Defect extending toward the right ventricle (arrows delineate the anterior leaflet of the tricuspid valve) (C) Defect extending toward the trabecular part of the right ventricle Shunt flow (arrows) does not delineate the tricuspid valve leaflets; the tricuspid valve orifice is denoted by arrowheads Ao, Aorta; LV, left ventricle; VSD, ventricular septal defect (From Freedom RMF, ed Congenital Heart Disease Textbook of Angiocardiography Armonk, NY: Futura.) FIG 32.36 A doubly committed juxtaarterial defect in the right anterior (A) and lateral views (B) The defect (asterisk) is in the outlet septum The pulmonary and aortic valves are seen in direct contact above the defect The initial shunt flow delineates the pulmonary valve in panel A, whereas in panel B a different patient with pulmonary hypertension the a right-to-left shunt flow is immediately below the pulmonary valve, well above the tricuspid valve AO, Aorta; LV, left ventricle; PA, pulmonary artery; RV, right ventricle (From Freedom RM, ed Congenital Heart Disease Textbook of Angiocardiography Armonk, NY: Futura.) FIG 32.37 Long-axis projections of left ventricular (LV) injections showing solitary (arrow) (A) and multiple (X) (B) muscular defects of the apical trabecular septum RV, Right ventricle