Right ventricular injection study in a dog with pulmonic stenosis and ventricular septal defect. The interventricular shunt (arrow) flows initially from the right ventricle (RV) to the left ventricle (LV) probably because of elevated RV pressure due to the power injector. (Compare with opposite flow during an LV injection shown in Case 018C).

Continued right ventricular injection study in the same dog. Note the contrast washout (CW) (negative contrast) below the pulmonic valve caused by left to right shunting of non-opaque blood through the ventricular septal defect.

Left ventricular injection study in the same dog. Contrast material passes from the left ventricle (LV) to the right ventricle (RV) through the ventricular septal defect (arrow).

Left ventricular injection study in the same dog. The enlarged pulmonary trunk (PT) and branches indicate that the ventricular septal defect flow is predominantly left to right. The contrast material remains in the heart longer than normal due to recirculation through the VSD.

Continued left ventricular injection study. Note the persistent contrast material (arrow) that was injected into the left ventricular (LV) myocardium.