Accuracy of two-dimensional echocardiography in the detection of aneurysms of the ventricular septum.

Eight children with angiographically proven aneurysm of the membranous ventricular septum (AVS) associated with ventricular septal defect were studied by real-time cross-sectional echocardiography. A curvilinear, sickle (dome-shaped), or irregular echo arising from the interventricular septum and bulging toward the right ventricle in systole was visualized in all patients. This finding was detected in 7 of 8 long axis views, 5 of 8 short axis views, 5 of 7 apex four-chamber views, and 4 of 7 subcostal four-chamber views. In addition, real-time cross-sectional echocardiograpic studies were performed in 40 patients with angiographically proven membranous ventricular septal defect without AVS; in only one patient was the abnormal echo suggesting aneurysm of the ventricular septum detected in the long axis and apex four-chamber views. Our echo study suggests that two-dimensional echocardiography has acceptable specificity for the diagnosis of AVS.