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| | THE MERCK MANUAL, Sec. 19, Ch. 261, Congenital Anomalies |
 | | Conduit repair of truncus arteriosus is sometimes possible, removing the pulmonary artery from the truncus and inserting a valved conduit to direct blood from the right ventricle to the pulmonary arterial tree. |
 | | However, in children with certain conditions (eg, congenital rubella, hypercalcemia syndrome [Williams syndrome]) and in some otherwise normal children, flow to branch pulmonary arteries is anatomically obstructed and may produce a continuous murmur. |
 | | Less common abnormalities (eg, Ebstein's malformation of the tricuspid valve), evidence of cardiac involvement with fetal disease (eg, prolonged in utero anemia, fetal dysrhythmia), severe cardiac anomalies associated with asplenia syndrome, and cardiac dysfunction secondary to noncardiac disease (eg, hypothyroidism) require individualized management. |
| www.merck.com /pubs/mmanual/section19/chapter261/261b.htm (4526 words) |
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