Pulmonary infundibular stenosis
A proportion of patients with ventricular septal defects develop pulmonary infundibular stenosis. The ventral septal defects may close and leave significant remaining pulmonary infundibular obstruction. The presentation of this condition is similar to pulmonary valve stenosis but with no ejection click (on auscultation :- loud pulmonary ejection murmur; second heart sound - as the obstruction progresses, right ventricular ejection is prolonged and P2 delayed and soft).
If the obstruction is severe then surgical infundibular resection is required.
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