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Right Ventricular Outflow Tract Lesions

Peripheral Pulmonary Artery Stenosis (Fig. 65-37)

Right ventricular outflow tract is a term that applies to patients with both peripheral pulmonary artery stenosis and an intact ventricular septum. It excludes those with an associated VSD, which is dealt with in the sections on tetralogy of Fallot and pulmonary atresia with a VSD. Also excluded is Noonan syndrome, which is dealt with in the subsequent section on pulmonary valve stenosis.

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Etiology

Rubella Syndrome

The most important cause of significant pulmonary artery stenoses producing symptoms in newborns used to be intrauterine rubella infection. Other cardiovascular malformations commonly found in association with congenital rubella include PDA, pulmonary valve stenosis, and ASD. Generalized systemic arterial stenotic lesions also may be a feature of the rubella embryopathy, which may involve large and medium-sized vessels such as the aorta and coronary, cerebral, mesenteric, and renal arteries. …