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One has to be careful when assessing muscular VSDs as there can be multiple defects, and thus imaging
from modified apical view making the interventricular septum perpendicular to the ultrasound probe and
slowly sweeping the septum can help [Figure 22].

Outlet VSDs are seen as defects between 12 and 3 o’clock when visualized in the parasternal short-axis views
with color flow directed towards the right ventricular outflow and pulmonary valve. They are at higher risk
for developing aortic valve prolapse and aortic regurgitation. As such, this has to be carefully assessed at
follow-up visits . Aneurysm of the sinus of Valsalva has also been described with outlet VSDs that can
[41]
progress over time [Figures 23-25].

CONCLUSION
Atrial and ventricular septal defects can occur in isolation or associated with other CHDs; together, they
account for the majority of the CHDs. Therefore, knowledge of septal embryology and anatomy is crucial to
understanding these lesions along with planning interventions. In addition, it is important to identify
associated lesions and potential complications. This chapter reviews various noninvasive imaging modalities
and how they can be utilized for these lesions.

DECLARATIONS
Acknowledgments
The author would like to thank Patrick Lynch for allowing the author to use his beautiful images.

Authors’ contributions
The author contributed solely to the article.

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The author declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.

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